Oral Answers to Questions

TRADE AND INDUSTRY

The Secretary of State was asked—

Manufacturing/Research and Development

Jim Cunningham: What steps his Department is taking to encourage manufacturing and research and development in Coventry, South and the west midlands region; and if he will make a statement.

Alun Michael: The manufacturing strategy has been designed by the Government to encourage manufacturers in all regions to move to high value-added production through the application of science and innovation, world-class practice and skills development. There is a long list of the support given by the Government, directly and through the regional development agency, but to save time I will send that to my hon. Friend.

Jim Cunningham: I thank the Minister for that answer and I appreciate that there has been considerable investment in the west midlands, but does he understand that we need considerably more, particularly in manufacturing—I am sure that he knows of events with Rover—where there is serious concern about the intentions of Peugeot? What discussions has he had with that company on future investment models?

Alun Michael: I recently met the chief executive of Peugeot, Mr. Folz, to discuss the issues and to stress my concern, which very much reflects that of local Members of Parliament. There was a positive response to the wish of the Government to work closely with the company and an understanding of our concerns and hopes for the future. These are obviously commercial decisions for the company, but we continue to maintain those contacts—for instance, my officials are having a meeting with the company in the next few days.

Julie Kirkbride: Can the Minister give us any information about the prospects of car manufacturing at Longbridge? He will be aware that the plant is now owned by the Chinese, and they have promised that they will reinstate a car business at Longbridge. However, we heard earlier this week that the first six months' option on the land owned by St. Modwen has lapsed. The Chinese can still produce cars if they take up that option, but does the Minister have any information as to whether they intend to do so and to make good their promises?

Alun Michael: The company is certainly saying that it intends to develop production in the way that has been promised and is publicly maintaining that position.

Richard Burden: Does my right hon. Friend agree that the west midlands has a really good research base—in Birmingham itself there are three excellent universities? All too often, however, the problem is linking that to development and translating it into products. He and my right hon. Friend the Secretary of State will shortly be considering the report of the MG Rover taskforce, and the key thing will be to ensure that technology corridors work and that that is translated into regeneration in the Longbridge area and the broader west midlands. That will regenerate local communities as well as attract investment to the area, which it so desperately needs.

Alun Michael: My hon. Friend makes a good point. He is aware that the grant given in recent times has included £32 million to the premier automotive research and development centre at Warwick university. He is right that the important thing is to link research and development work to the sharp end of business. There is a very good story to be told by the automotive industry in the west midlands, and we want to support that and see it continue.

Michael Fabricant: Notwithstanding the recent announcement of the closure of GKN in Lichfield, the Minister is right to stress that businesses and manufacturing should concentrate on high-value production, but what can he do about the tax credit system for research and development? Although it is a good system in principle, it is very difficult for smaller high-tech industries to claim R and D tax credits. They vary so much from region to region and inspectors make different value judgments on whether a project is an R and D project. The problem is that there is no consistency in the United Kingdom or ease in applying for such a tax credit.

Alun Michael: Sometimes it is down to a lack of information and of knowledge on the part of companies. We want to promote such information. For instance, the Manufacturing Advisory Service has generated £212 million-worth of added value for companies. We want to spread that knowledge and understanding. Secondly, since its inception, the research and development tax credit has provided £795 million in Government support, the majority of which has been for manufacturers. The hon. Gentleman makes the important point that there is a need for greater knowledge and to ensure that it is applied at the sharp end.

Brian Jenkins: My right hon. Friend will be fully aware that manufacturers move into and expand in an area only if there is a skilled work force to produce their products. He will also be aware that the west midlands work force have the lowest level of qualifications. Has he had discussions with my right hon. Friend the Secretary of State for Education and Skills on plans for joined-up government to improve the qualification base in the west midlands?

Alun Michael: My hon. Friend makes an important point. We are working closely with colleagues at DFES to ensure that there is a proper focus on the development of skills. One way of ensuring that that happens properly is the work to link the regional development agencies with the skills bodies, particularly through the regional skills strategy. We have, too, the manufacturing academy, which is being developed in a positive way to make sure that the skills at every level through industry are appropriate to its needs. That must be done by focusing on the regional and local need in the way that he suggests. That is very much at the forefront of our minds.

Alan Duncan: Following the disastrous intervention of the right hon. Member for North Tyneside (Mr. Byers) in the sale of Rover, which unfortunately sealed its fate, it now turns out that the sale of the Longbridge plant to Nanjing was somewhat botched. There is, however, some potentially good news: there is a serious prospect of moving the plant from Longbridge to Coventry so that car production can resume. What can the Minister tell the House about that? [Interruption.] Is he prepared—now that he has had something whispered in his ear—to engage fully with Nanjing and all the investors involved in trying to make that happen and, in doing so, to encourage the project, give grants where appropriate and attend any meetings that might assist the project?

Alun Michael: The hon. Gentleman seeks to promote misery and misapprehension by his comments. He should be aware that the Government and colleagues in the Department are fully engaged in all these issues to try to achieve the best possible outcome. As I suggested earlier, there is every indication that the company intends to pursue the intended prospects. He referred to employment, and he is surely aware that it is at virtually its highest level for the past 15 years.

International Trade

Andrew Selous: If he will make a statement on his Department's policy on increasing the UK's share of international trade and inward investment.

Ian Pearson: Overseas trade is an essential part of the UK's prosperity. UK Trade & Investment helps companies in the UK to develop their businesses internationally. UKTI also works to attract high quality inward investment and the UK is the No. 1 location in Europe for inward investment.

Andrew Selous: The United Kingdom's 2005 trade deficit was not only the largest ever at £47 billion, it was a fifth larger than the year before. Even within the European Union, we are running a trade deficit in goods of some £3 billion a month. Do the Government think that we, as a country, can go on indefinitely importing more than we export? Even Belgium sells more to India than we do.

Ian Pearson: The UK's trade performance with India is growing strongly and it is absolutely right that we do more to trade with China, India and other emerging markets. Our trade deficit is about 2 per cent. of gross domestic product. The United States trade deficit is 6 per cent. of GDP. In 1989, under a Conservative Government, our trade deficit was 5.1 per cent. Our current account deficit is forecast to widen a little this year, but it is easily sustainable.

Rob Marris: In terms of international trade, two growing areas are medical technology, and pollution control equipment and environmental control materials and so on. What is the Department doing to encourage UK companies to invest, research and export in those two sectors?

Ian Pearson: My hon. Friend is right to point out that those are two important areas. Certainly, with regard to countries such as China, health care and pollution technology are recognised as key priority areas where we have expertise in the UK in our research base and in many of our companies. We are actively supporting those companies to win business contracts in China. It is not just China, but India, Brazil and other emerging markets where we need to up our economic performance in such areas and in other sectors as well.

Peter Luff: I think that the Minister said two slightly contradictory things. In answer to my hon. Friend the Member for South-West Bedfordshire (Andrew Selous), he said that our trade performance in India was very good. Now, quite rightly, he has just said that we need to up our game. Has he seen the recent survey from KPMG that suggests that British businesses are retreating to the comfort blanket of north America and Europe and are largely ignoring the opportunities in the emerging and developing economies of the world? What can the Government do to re-engage those companies and help them to rediscover the sense of enterprise and adventure that created the wealth that we now enjoy in this country?

Ian Pearson: I did say that our trade with India is increasing, and that is to be welcomed, but to quote a Japanese quality guru, Shigeo Shingo,
	"Those who are not dissatisfied will never make any progress."
	We need to improve continuously trade performance, just as our manufacturing and other industries need to improve continuously. I am aware of the study to which the hon. Gentleman refers, and I want to see more UK companies taking advantage of the opportunities available in the emerging markets of China, India, south-east Asia, Brazil, South Africa, Mexico and other countries.

John McFall: I acknowledge the importance of manufacturing industry, but the Minister is aware that service industries account for 70 per cent. of gross domestic product. What specific initiatives in the emerging markets of China and India is he undertaking to ensure that companies already in those countries and doing well in the financial services industry are given further stimulus from the Department of Trade and Industry?

Ian Pearson: My right hon. Friend is right to point out the importance of the service sector to the UK economy and to our international trade. He knows that Lloyd's of London managed to enter the Chinese market. The deal was sealed during President Hu Jintao's state visit to the UK last year. We are doing a great deal on financial services in both China and India, working with the Mayor of London and a number of others to open up the insurance, re-insurance and financial services markets. These are areas where the UK has a great deal of expertise. Public-private partnerships are another aspect of financial services where we have tremendous expertise, which we can trade internationally. There is a great deal of work going on, particularly in China and India and through the joint economic trade relationships that we have with those two countries.

Geoffrey Clifton-Brown: My hon. Friend the Member for South-West Bedfordshire (Andrew Selous)—

Mr. Speaker: Order. If the hon. Gentleman is unhappy about who I call, he is out of order. Those on the Conservative Front Bench make a demand on these questions, and I am obliged to call Front-Bench Members. That means that Back Benchers lose out.

Nicholas Winterton: Further to your observation, Mr. Speaker, which was obviously directed—

Mr. Speaker: No, there are no points of order. I will not take the hon. Gentleman complaining—

Nicholas Winterton: I never complained. I never uttered a word.

Mr. Speaker: Well, that is news to me. I have heard him complain. Mr. Clifton-Brown.

Geoffrey Clifton-Brown: My hon. Friend the Member for South-West Bedfordshire has the done the House and the country a favour by drawing attention to our record trade deficit, up 25 per cent. on last year. Yet at the same time the United Kingdom's main trade and investment body, UKTI, has had its budget cut this year by £6 million. The Government's obsession with fragmentation and dilution to the rural development agencies and the devolved Assemblies is blurring our trade effort throughout the world. Is it not a fact that UK plc's trade and inward investment effort could and should be a great deal more effective?

Ian Pearson: The hon. Gentleman tried to get angry, but the simple fact is that UKTI has a budget of £280 million per annum. It helps companies in over 100 markets worldwide through its network of posts and staff. It provides a range of services. According to the most recent trade figures, our export volumes are 9.7 per cent. higher than in the same period last year. Value for money is important to the Government, and £65 million was spent on four main business support programmes. That helped 6,000 companies and produced £1.1 billion in net additional benefit. By any measure, that must be good value for the taxpayer's money.

Michael Clapham: I hear what my hon. Friend says about the increasing trade with India and China, but does he believe we are doing as well as our competitors? For example, are we encouraging joint ventures at the rate at which we ought to be doing so, and are we encouraging larger companies to piggy-back smaller companies into those markets—a measure with which the Germans were very successful in the mid-1990s? Are such initiatives being taken up by UKTI?

Ian Pearson: My hon. Friend makes several good points, and I can assure him that UKTI is taking them up. Our performance is lagging behind in relation to India—we should be doing better. We have strong historical and cultural ties with India, and we are not leveraging those to maximum benefit. I am dissatisfied with that, and I want us to make more progress. We have made great strides with China in recent years. There is a bumper crop of exchanges at top levels. We have formalised relationships through the joint economic trade committee, and that is bearing fruit. Exports to China are up massively. Two-way trade and investment is growing strongly, and I am sure that it will continue to do so in future years.

Energy Prices

David Amess: If he will make a statement on recent increases in energy prices.

Alan Johnson: The recent increases in energy prices are causing great concern, particularly in relation to their impact on industrial competitiveness and fuel poverty. Prices are rising mainly as a result of increasing oil prices, leading to higher wholesale gas prices, and higher international coal prices. I can assure the House of our determination to reduce the impact on those least able to cope.

David Amess: As the sponsor of the Warm Homes and Energy Conservation Bill, now enacted, which committed the Government to eliminating fuel poverty within a set period, does the Secretary of State share my concern that gas prices have increased by 38 per cent. and electricity prices by 30 per cent. since October 2003, pushing another 200,000 people into fuel poverty? What does he intend to do to address that very worrying trend?

Alan Johnson: The hon. Gentleman is absolutely right to raise this issue. I congratulate him on his sponsorship of the Warm Homes and Energy Conservation Bill in 2000. Fuel poverty is the most serious consequence of rising gas prices. We have had great success in pulling more than 4 million people out of fuel poverty, but the fact that it is defined as fuel taking up more than 10 per cent. of one's income automatically means that people on fixed incomes, particularly pensioners, will get pushed back into fuel poverty, so those figures are bound to rise.
	We have to put more money into the projects that help people to tackle those problems. My right hon. Friend the Chancellor of the Exchequer announced in the pre-Budget report an extra £300 million for this area, £250 million of which will be dedicated to the Warm Front campaign in England. There will be a total of more than £800 million. We need to ensure that elderly people use the helplines that are set up to give them advice on what to do. We also need to give them the confidence to switch suppliers, because doing that, in our competitive environment, can save up to £60 per year, which is significant for the kinds of people who are particularly affected. We have to consider those and a whole range of other measures, including the winter fuel allowance, which my right hon. Friend the Chancellor has announced will be in existence for the whole of this Parliament. Those are all crucial issues. The hon. Gentleman is absolutely right to raise the matter and to try to ensure that we tackle this difficult problem.

Paddy Tipping: Reliable indigenous affordable fuel supplies can reduce costs. What steps is my right hon. Friend taking to support UK Coal? In particular, when will he make an announcement on the loan guarantee application at Harworth colliery?

Alan Johnson: We are helping UK Coal inasmuch as it is private company that makes its own commercial decisions. In relation to Harworth, we are in discussions, as my hon. Friend knows. I congratulate him and other hon. Friends on raising this important issue. We are hoping to find a solution, providing that it does not breach state aid rules and is consistent with the need to ensure that there is a proper economic outcome for the taxpayer. We will announce the result of our deliberations as soon as we can.

Norman Lamb: Does the Secretary of State agree with this morning's statement by the chairman of Ofgem, Sir John Mogg, that British consumers are paying nearly £1 billion more for gas this winter as a result of the failure of the interconnector to import at the full rate and the lack of effective competition in the European energy markets? Does he accept the Energy Watch estimate that by the end of this year 3 million households will be in fuel poverty compared with just 1.2 million in 2003? We have a combination of a lack of liberalisation of markets and a failure of Government policy to eradicate fuel poverty. Energy Watch points to myriad different schemes—

Mr. Speaker: Order. That is enough supplementaries—the hon. Gentleman must finish.

Alan Johnson: I agree with the comment made by the chairman of Ofgem this morning. Opposition Members claim that Government policy on fuel poverty has failed, but our record is excellent, and hon. Members on both sides of the House should commend our taking 4 million pensioners and disabled people out of fuel poverty. May I put the increase in prices in context, Mr. Speaker? The issue involves not only the UK, but Germany, where wholesale gas prices have increased by 75 per cent., and Denmark, where they have increased by 50 per cent. The central questions are how we help the fuel poor tackle the problem and how we liberalise the EU market, which, as the hon. Gentleman has rightly said, is a major factor in the problems that we face this winter and next.

Anthony D Wright: The Government should be proud of having eradicated fuel poverty for 4 million households. However, there are particular problems, and security of supply is also an issue. Will the Langeled pipeline, which will come on stream in 18 months' time, affect the price of gas? What talks has the Secretary of State held with industry on that development and on eradicating fuel poverty in households across the country?

Alan Johnson: My hon. Friend is right to raise that issue. Langeled will lead to a 16 per cent. increase in our gas supplies. Next year, we will have the gas pipeline from Easington to Norway and the new BBL interconnector with the Netherlands, so the problem should ease. If we are to have a mature debate, however, we must accept that the days of plentiful, cheap, indigenous energy are gone—we can probably wave goodbye to the prices that we enjoyed for many years. Our position is the same as that of almost every other G7 country—only Canada has sufficient indigenous supplies to be a net exporter of energy, and, like every other major economy, we will become a net importer of energy. Perhaps reflection on the days of cheap, indigenous energy being gone for good will focus us on energy efficiency, on which we can do a lot more.

Charles Hendry: To pick up on the Chinese proverb, the Secretary of State sounds dissatisfied, but he is not making much progress. Eighteen months ago, British small businesses paid 12 per cent. less than French small businesses for their energy, but now they are paying 15 per cent. more. Companies renewing their energy contracts this spring are being told to get ready for price increases between 60 and 100 per cent. The Government wasted a unique opportunity during their EU presidency to make European energy markets more efficient. Now that businesses and consumers are paying the price, does the Secretary of State understand why they are so angry?

Alan Johnson: I hope that we are not going to get a series of displays of superficial anger from Opposition Front Benchers. If the hon. Gentleman wants knockabout, I have got all the figures: in the nine years since 1997, the average price for energy was 23 per cent. lower than in the nine years before 1997, and UK domestic gas prices have only just returned to their 1990 level. We have a good record on energy and climate change. On the problems that companies face now, it would be disastrous if we were to interfere in the market, and we must ensure that we have the proper liberalisation of the EU energy market. The hon. Gentleman has said that we wasted the six months of our presidency, but it is a bizarre idea that having the presidency allowed us to click our fingers and make everything change. We have put in place mechanisms to change the situation, and I hope to provide further details later in answering the question tabled by the hon. Member for Banbury (Tony Baldry).

Gas Supplies

Huw Irranca-Davies: What measures are in place to increase capacity for gas supply and storage in the UK.

Malcolm Wicks: By 2010, Britain's gas market will have received some £10 billion of investment in new gas storage and import projects. In addition, we intend to bring forward legislation to facilitate innovative new offshore storage and supply projects. We are also working to ensure that there are no unnecessary non-commercial barriers in the existing regulations to new onshore gas storage projects.

Huw Irranca-Davies: The Minister knows that we are playing our part in Wales with the new Pembrokeshire facility. He will recognise that we need a much wider, balanced portfolio of energy products. What future does he envisage in the energy review for marine tidal energy off Wales, coal production in Wales and clean coal technology? We have a great part to play but it must be wider than one confined to imported gas.

Malcolm Wicks: The Government are investing heavily in research and development for marine tidal, which is part of a new range of technologies that we need to take seriously. On clean coal technology, we have a fund of some £35 million for carbon abatement projects. We have, in principle, much indigenous British coal and, with clean coal technology, there should be a future for it. That is a feature of our energy review.

John Hemming: The Minister has been rescued by the Atlantic from any further problems of gas supply this winter. However, does he have any proposals to ensure that perverse market actions, whereby gas is taken out of storage rather than imported on the interconnector, do not occur in future?

Malcolm Wicks: I do not believe that the Secretary of State or I have been rescued by the mighty Atlantic. There were always Jeremiahs about this winter, who will want to look at what they said come April. Supply is plentiful but we recognise the problem of prices for intensive users. As we speak, there is plenty of gas in storage. Although we are not complacent, with the Langeled pipeline and the rest coming on stream later this year and more storage projects, we face a better future than our experience this winter suggested.

Eric Illsley: My hon. Friend said that gas supplies are plentiful and that we have plenty of gas storage, which tends to suggest that problems of supply were not the cause of the quadrupling of industrial short-term gas prices in November, which continues to affect the market. Heren Energy forecasts a short-term gas price of around 70p per therm this summer compared with 40p in the same period last year. Will my hon. Friend examine gas trading, bearing in mind that the biggest buyer of industrial gas in this country is Barclays bank? He must investigate the trading aspects of gas.

Malcolm Wicks: We need to understand better what happened this winter. Although there was a plentiful supply and the Jeremiahs were wrong, intensive users, usually buying short term and often on the daily spot market, paid very high prices. The commercial sector needs to reflect on that and so do we. As the Secretary of State said, things are changing and the days of cheap prices are probably gone for ever but there is more supply capacity into Great Britain and that should ease the position, albeit in the context of a huge global demand, not least from China, for the world's energy.

Alan Duncan: After eight years in office, what is the Government's policy for establishing onshore strategic energy stocks that stand a chance of lasting more than 11 days?

Malcolm Wicks: We have not only a policy but practice. Next winter, Britain's import capacity will be double today's figure. By winter 2009–10, it could be trebled. Investment in new gas stocks is increasing all the time. We will have more capacity for storage next winter and the following winter than previously. The issue that the hon. Gentleman raises is a feature of the energy review.

Intellectual Property Crime

Robert Flello: What steps the Government are taking to combat intellectual property crime.

Barry Gardiner: The UK is widely recognised as one of the lead countries in the world on intellectual property enforcement. Through the Patent Office, the Government have implemented the national IP crime strategy. It put in place a multi-agency IP crime group, involving Government, public enforcement bodies—including police, trading standards, Her Majesty's Revenue and Customs—and key industry sectors to deliver better-targeted enforcement action. In December 2005, we carried out the first multi-agency operation at Wembley market in London, where more than £1.5 million of counterfeit and pirate goods were seized. I pay particular tribute to Brent police and Brent and Harrow trading standards for leading the action. There were a number of arrests, which are being pursued to prosecution by trading standards and the police.

Robert Flello: I am grateful to my hon. Friend for that response. Given my interest in the ceramics industry, and the pressure that that industry is under from rapidly rising energy prices, will my hon. Friend explain what measures specific to that industry are being considered to ensure that the theft of ideas and designs does not become yet another nail in the industry's coffin?

Barry Gardiner: The whole House is aware of my hon. Friend's strong support for the ceramics industry, with which his constituency has long been proudly associated. He is right to point out the threat that the industry faces from counterfeit goods, particularly from China and the far east. We have developed specific training programmes to ensure that Chinese enforcement agencies develop strategies to stop such infractions at source. Last year, the Chinese Government reduced the threshold for offences there, and in the past year there has been a 23 per cent. rise in successful actions in the Chinese courts against such perpetrators. In the European Union, under directive 85/500/EEC, we have been campaigning to ensure that a back stamp goes on to ceramic goods, which will help to prevent counterfeit goods from entering this country.

Philip Hollobone: Which countries does the Minister regard as offering best practice in regard to the protection of intellectual property rights? What lessons are to be learned from them?

Barry Gardiner: As I said earlier to my hon. Friend the Member for Stoke-on-Trent, South (Mr. Flello), this country has one of the proudest records on the protection of intellectual property rights. We have been working with our partners in Europe to develop that further as an EU-wide strategy, because this is an issue that all developed countries are facing. As we seek to make the UK the hub of the intellectual creative industries, not only for Europe but for the world, it will be increasingly important to have provisions in place to protect not only our ceramics market but the music industry and all the other creative industries for which this country is so well positioned.

Nuclear Power Stations

David Drew: If he will bring forward earlier comprehensive decommissioning of nuclear power stations.

Malcolm Wicks: The Nuclear Decommissioning Authority has set out its proposals for the decommissioning and clean-up of its sites in its draft strategy. The Scottish Ministers and I have until 31 March to consider and approve the proposed draft.

David Drew: I thank my hon. Friend for that response. He will soon receive a report from those involved with the Berkeley site in my constituency, which contains exciting proposals for the next stage of the decommissioning and clean-up of the site. I hope that he will look favourably on the proposals, and ensure that there is a proper role for both the public and private sectors in undertaking the work. I hope that he will have some positive things to say on that.

Malcolm Wicks: I hear what my hon. Friend says. The clean-up of our waste legacy is one of the big challenges that we face; in my judgment, it should have been tackled before now. We now have in place the Nuclear Decommissioning Authority, and an expert committee will be advising us in the summer on the equally important issue of a final repository for nuclear waste. Once both of those are in place, we shall be in a position to discuss with the public—should we need to, and should that be our decision—the future of civil nuclear power in this country.

Kitty Ussher: Does my hon. Friend agree that the costs of nuclear decommissioning depend very much on the methodology used, and in particular on the discount rate that is applied? In the context of the present energy review, will he commit at an early stage to publish the Government's methodology, so that we can have a proper debate on the issue before the conclusions of the review are reached?

Malcolm Wicks: We are looking at the economics and carrying out a cost-benefit analysis of a range of technologies, and I will certainly consider what my hon. Friend has said. By any judgment, the cost of clearing up the nuclear legacy, calculated over time—possibly 50 or more years—is estimated at £56 billion, with the annual cost at present about £2 billion. This is a very expensive project, and I shall consider what my hon. Friend has said.

European Energy Market

Tony Baldry: When he next expects to meet the European Commissioner with responsibility for competition to discuss opening up the European energy market.

Alan Johnson: I last met Competition Commissioner Neelie Kroes to discuss opening up the European energy market and other issues on 27 January 2006. I continually emphasise to the Commissioner that she has our full support for the sector inquiry that she is carrying out and that we look forward to seeing the results.
	The inquiry's initial report in November last year identified a number of issues in the European energy market, in particular a lack of unbundling and transparency in some parts of the EU. We hope that the latest report, which is published today, will build on those findings and that it will identify individual cases where there has been a distortion of competition.

Tony Baldry: The Secretary of State earlier drew the House's attention to the new realities in the electricity markets and the Prime Minister told the House yesterday that it is very important that we have a level playing field in energy pricing. Can the Secretary of State promise the House that the Government have got a grip on this; that time is of the essence; that competitiveness for the UK, and indeed for Europe, will be critical in terms of energy pricing, as we have the highest wholesale gas prices in Europe; and that this will not be shuttled off so that, whenever we ask a question, we are told that the EU Commission is dealing with it? We all want the understanding and the guarantee that this is something that the Government are genuinely taking seriously and that we are not just getting some holding line to take.

Alan Johnson: I think that the hon. Gentleman is absolutely right. What happened over Christmas between Russia and Ukraine was a wake-up call for the rest of the EU. It builds on the suggestion, which we made at Hampton Court during our presidency, that the EU needs to get a grip of this issue, right across the EU. Earlier I mentioned Germany. Its prices have gone up 75 per cent. wholesale, and 41 per cent. of its supply is dependent on Russia.
	There is a question first of liberalisation. In that respect, not only the industry sector report is important. We also instigated a report on the specific incidents last year when gas was not coming through the interconnector. The Chancellor and I wrote to the Commissioner, and there is a separate inquiry on that. There is a third inquiry, which the transport and energy directorate-general is handling, to consider whether additional measures are needed to enable the internal energy market to develop properly.
	There are three strands there in the EU, as well as the wider question of the geopolitical issue. There is a real need to ensure that, in future, our energy supplies are not dependent on some unstable countries and some countries that are huge monopolies and able to exert the power that huge monopolies can.

Denis MacShane: I congratulate my right hon. Friend on keeping the home fires burning while in Italy, by contrast, power cuts are leading to central heating being switched off and Italians having to snuggle under their blankets and stay warm in bed together, which might explain why the Italian Prime Minister has given up sex for the general election. Will my right hon. Friend send one of his excellent Ministers to Italy to show how a sensible energy market might be run?
	On a specific point, waiting for Europe to do what we want might mean a long wait. The profits of the British glass industry have been wiped out by the rise in gas prices and 150 jobs in my constituency of Rotherham went yesterday, in part because of high energy prices.

Mr. Speaker: Order. The Italian part was all right.

Alan Johnson: My hon. Friend the Minister for Energy has just said that the energy review will look very carefully at two people snuggling together under a blanket as one solution to our problems for the future. As for the situation in Italy, I think I need to go myself.
	My right hon. Friend the Member for Rotherham (Mr. MacShane) raises an important point, and the glass industry in particular has been severely affected by the price increase. It is still the case—I say this although it offers little comfort to those affected—that over the past 10 years British companies have paid £9 billion less for their energy than German companies, for instance, but there is an issue here that we need to tackle.
	We are working with the energy-intensive users such as the company in my right hon. Friend's constituency to get the right transparency, to see what we can do to reduce energy consumption and to avoid what happened in Italy, which was a disastrous imposition by Government that we want to avoid at all costs in this country.

Owen Paterson: De la Rochefoucauld said:
	"Every man complains of his memory but no man complains of his judgment".
	What happened in Ukraine was a reminder of how successive Russian regimes have treated weaker neighbours. What, in the Secretary of State's judgment, is the maximum percentage of gas that should be imported from Russia?

Alan Johnson: I have never thought about what the maximum should be. All I know is that the Ukraine- Russia spat did not affect the UK, because none of our gas comes from Russia. If we do nothing, however, and carry on decommissioning nuclear plants, and decommissioning coal-fired plants because of emissions problems, by 2020, 80 per cent. of our gas supplies would have to be imported. It is inconceivable that a large chunk of that would not come from Russia. That is a specific reason why the review needs to go right across the field, considering renewables, energy efficiency, nuclear, fossil fuels and clean coal technology. The hon. Gentleman is right that we need to ensure, not just in this country but throughout the European Union, that the dominance of Russia does not become a real problem in future, as it was for Ukraine over Christmas.

Dennis Skinner: Does the Secretary of State agree that if we are to remove ourselves from the stranglehold of rising gas prices, enormous reliance on gas and all that goes with it, we need to make sure that our coal industry does not fade away? There are only half a dozen pits left, one of which is Harworth, which has 288 miners. Its coal is important, and he should make sure that the loan guarantee is granted. If there are any problems in the tinpot Common Market, he should tell that Commissioner to pull her finger out and allow those miners to work.

Alan Johnson: I refer my hon. Friend to the answer that I gave to my hon. Friend the Member for Sherwood (Paddy Tipping) in relation to Harworth. There is an opportunity for coal, because rising gas prices have meant that coal has become much more competitive. Imports from South Africa and other countries, however, are still far cheaper than indigenous coal. Nevertheless, the advent of new technology such as carbon capture and storage provides an opportunity to consider coal with a completely fresh eye. Things have moved on even from the 2003 White Paper. The support for the coal industry that my hon. Friend the Member for Bolsover (Mr. Skinner) has given over the years will be important in relation to the energy review.

Bank Charges

Andrew George: What recent assessment the Office of Fair Trading has made of the regulation of charges imposed by banks on their customers.

Gerry Sutcliffe: The OFT wrote to eight major credit card companies in July 2005 to consult on its provisional conclusion that the default charges that they impose are excessive. The investigation is continuing.

Andrew George: I thank the Minister for that answer. Since the finding that some of those charges are unfair under the Unfair Terms in Consumer Contracts Regulations 1999, however, the OFT has failed to act on its three-month deadline to demand that the banks either seek to justify or remove those charges. A large number of customers have challenged those and received out-of-court settlements, because the banks are not prepared to defend the cases. In view of the fact that the Government are keen to encourage low-income families and those in receipt of benefit to open bank accounts, can the Minister assure the House that they will do everything that they can to inject urgency into the inquiry and to make sure that customers are properly protected?

Gerry Sutcliffe: The hon. Gentleman knows that the OFT is an independent agency, and it would be wrong for the Government to interfere in its investigation. I know that he has had correspondence with the OFT. The Government are committed, however, to supporting low-income families in getting bank accounts, as we are to examining consumer credit, which is why we introduced the Consumer Credit Bill. I am sure that he will achieve what he wants in due course, but I will write to him as soon as I have any information from the OFT.

Nigel Dodds: Will the Minister join me in welcoming the opening of hearings by the Competition Commissioner in Belfast today following a referral to the OFT by the consumer council of a super-complaint about high charging for customers in Northern Ireland? Does he agree that it is essential that customers, business and domestic consumers in Northern Ireland should have the same level of competition and charges as our counterparts in the rest of the United Kingdom?

Gerry Sutcliffe: I am grateful to the hon. Gentleman for raising this matter, which proves that the process works. Through the Enterprise Act 2002 and the Competition Act 1998, the opportunity to have the super-complaint means that disparities in the marketplace can be investigated and consumers can have a voice. I welcome his comments and the inquiry.

Rolls-Royce Contract

John Robertson: What discussions he has had with the US Administration concerning the cancellation of the contract for the GE Rolls-Royce F136 engine.

Alun Michael: The issue of the F136 engine has been raised with the United States Government at all levels. Although it is not in the Administration's current budget proposals, we will keep pressing the case for the engine. That will not reach a conclusion until the US Congress has approved the budget.

John Robertson: I am sure that my right hon. Friend realises how important the engine is to GE and Rolls-Royce. Will he redouble his efforts to ensure that the project does not end up on the scrap heap, that we do our bit for the air fighters and their engines, and that the workers, particularly those in Rolls-Royce, are looked after?

Alun Michael: I am sure that the engagement of everyone up to my right hon. Friend the Prime Minister will reassure my hon. Friend about the efforts that are being made. It is worth pointing out that the F136 project is a joint project between the two companies, in which Rolls-Royce has a 40 per cent. share. A cancellation would therefore have serious implications for American business as well. We will certainly maintain our efforts to achieve a positive outcome.

Tobias Ellwood: The consequences of the ITAR waiver, which is at the heart of the issue, have affected not only Rolls-Royce but other companies. What measures is the Minister taking, not just in regard to Rolls-Royce but in regard to the wider impact on the relationship between the United States and Britain, bearing in mind our close collaboration on both military and civil projects? If that breaks apart, and if we do not have the necessary guarantees, many more companies than Rolls-Royce will be affected.

Alun Michael: The relationship between British and American industry, as well as our relationships on defence issues, is extremely important, and the hon. Gentleman is right to refer to it. I refer him to the defence industrial strategy, which my right hon. Friend the Secretary of State and I supported along with our colleagues at the Ministry of Defence. The strategy document is very significant for the defence industry.
	At the beginning of the week I visited Rolls-Royce in the Bristol area. I was particularly struck by the engagement down the supply chain in improving efficiency and competitiveness, and the involvement with our defence industry's real needs at every level.

MINISTER FOR WOMEN

The Minister for Women was asked—

Family-friendly Employment Rights

Janet Dean: What measures the Government are taking to secure family-friendly employment rights for parents and carers.

Meg Munn: The Work and Families Bill builds on the strong foundations of support that we have already introduced for working families. It proposes to extend maternity and adoption pay, give fathers a new right to additional paternity leave, and extend the flexible working law to carers for adults.

Janet Dean: I welcome the proposals, and the progress that has already been made with family-friendly policies. What analysis has my hon. Friend conducted of the impact of maternity and paternity rights on both industry and families?

Meg Munn: Companies that take account of the need for flexible working and recognise that they need to draw from the whole pool of talent, men and women, generally do better. Keeping an employee in work following maternity leave is often far less expensive than recruiting and training someone new.
	Let me take this opportunity to congratulate the right hon. Member for Witney (Mr. Cameron) on the birth of his child. I note that he is taking paternity leave, which I am sure will benefit his family. He did not, of course, vote for that right; nor did his party.

Philip Hollobone: What discussions has the Minister had recently with her ministerial colleagues about improving the provision of respite care for those who look after adults?

Meg Munn: We take the issue of carers' rights very seriously in the Work and Families Bill. We have issued a consultation document on the definition of carers. That is obviously connected with the issue of respite care, and discussions are ongoing. Respite care, along with flexible working, obviously helps those with caring responsibilities to go on working, which is often in their interests and those of the people for whom they care.

Barbara Keeley: I am currently advertising a post in my constituency office that I have opened up to job sharing, and I hope that lots of other Members do the same. What steps are being taken to encourage other employers to open jobs up to job sharing?

Meg Munn: We introduced three years ago the right for parents of children aged under six, and of disabled children aged under 18, to request flexible working. Flexible working covers a range of areas, including job sharing, and the right to request it has proved very successful for employers and employees. So the encouragement is there to look at all types of flexible working, including job sharing.

Lindsay Hoyle: I recognise that family-friendly policies are very important in enabling people to continue in work. What measures has my hon. Friend put in place to help industry to implement such policies, and what financial support can she provide in that regard?

Meg Munn: We consulted widely on the issues with which the Work and Families Bill deals—it is being led by the Under-Secretary of State for Trade and Industry, my hon. Friend the Member for Bradford, South (Mr. Sutcliffe)—and they were examined carefully to ensure that we proceed at the right rate. We have decided not to extend the right to request flexible working to families with children aged over six at this stage, but to consider introducing that right on a steady basis. The costs associated with introducing flexible working arrangements are minimal—much less than those arising from having to recruit new employees.

Eleanor Laing: I am glad that the Minister recognises that my right hon. Friend the Member for Witney (Mr. Cameron) will now discover that looking after a new baby is even more difficult than leading the Conservative party. [Hon. Members: "Oh no it is not."] Oh yes it is. She will also recognise that we Conservatives have supported the measures in the Work and Families Bill, but will she undertake, in considering the regulations following on from that Bill, to get the balance right and to make sure that unnecessary burdens are not placed on small businesses? If the balance is wrong and too many burdens are placed on them, that will be bad for such businesses, bad for their employees and bad for families.

Meg Munn: I agree with the hon. Lady that it is important to get the balance right, which is why we have proceeded at the rate that we have. We have not rushed into these matters, and we have consulted business. She will know that small businesses are often the best at introducing flexible working; indeed, they often adopt such practices so that they can ensure that their small number of employees can cover the work, and that they can get the right people in. There are skill shortages in many fields, and they are often the ones in which women are under-represented. So getting more women into the labour market in those fields will help such businesses, rather than preventing them from making progress.

Pensions (Women)

Adam Price: When the Government will publish their report on the pension position of women.

Tessa Jowell: Last November, the Government published an analysis of women's pensions. The evidence showed that 30 per cent. of women retiring today are entitled to the full basic state pension, but that by 2025, on average, more than 90 per cent. of both men and women will be entitled to the full basic state pension—a figure that reflects the much larger number of women in work.

Adam Price: I thank the Minister for her reply. The Government should be congratulated on the detailed analysis set out in that report. I hope that such reports will become an annual event, until we get genuine pensions equality between men and women. Are the Government finally going to scrap the 25 per cent. rule whereby women with less than 10 years-worth of contributions do not qualify for the full pension?

Tessa Jowell: I thank the hon. Gentleman for his question and for his congratulating us on the approach that we are taking to one of the most intractable issues that we face. No decisions have yet been taken about the final settlement. My right hon. Friend the Secretary of State for Work and Pensions will in due course publish proposals, in response to the Department for Work and Pensions' own evidence and that of the Pensions Commission. I should point out that fairer pensions for women is one of our key objectives, given the scale of such inequality and the risk of poverty in old age that too many women still face today.

Anne Begg: My right hon. Friend mentioned the Pensions Commission, which recognised that the present system was designed by men for men and reflects a society that no longer exists. Will she put pressure on my right hon. Friend the Secretary of State for Work and Pensions to ensure that the White Paper addresses the question of women and their pensions and that the present inherent inequalities are ended once and for all?

Tessa Jowell: My hon. Friend is right. The deep-rooted gender inequalities reflect the different nature of the working lives of men and women, and addressing that problem is one of the most important challenges involved in getting the new pensions settlement right. We are actively engaged in discussions about how to do that.

Sandra Gidley: Home responsibilities protection provides a welcome but partial solution to pension poverty among people who have had caring responsibilities, but it can be unfair. For example, a woman with 20 years of home responsibility and 10 of employment accrues only 50 per cent. of the basic state pension, whereas a man with a 30-year employment record accrues 70 per cent. Will the Minister commit to making the system fairer for those with caring responsibilities?

Tessa Jowell: I have made it absolutely clear that achieving equality between the positions of men and women is one of the key outcomes that the Government are determined to achieve in the new pensions settlement.

Human Trafficking

Mary Creagh: What discussions she has had with the Home Secretary on the steps that he is taking to provide victims of trafficking with specialist care and protection to enable them to make choices about whether to remain in the United Kingdom.

Meg Munn: As a member of the ministerial group on human trafficking, I work closely with Home Office colleagues to ensure that provision for victims is sensitive to women's needs. We have a comprehensive support scheme to help women make informed decisions about their futures. Our consultation on a UK action plan includes plans to further develop support arrangements.

Mary Creagh: I thank my hon. Friend for that reply. May I urge her to work with her colleagues to ensure that we sign the European convention on action against trafficking in human beings? That would give victims an automatic cooling-off period to recover from the sexual abuse that they have suffered.

Meg Munn: I pay tribute to my hon. Friend's interest in this very important matter. She will know that the Government were involved when the action plan was drawn up, and that we are considering moving towards signing it. Our concern is that automatic periods could act as a pull to bogus asylum claims, but we are looking at the experience of other countries. We consider all victims on their merits: the cooling-off periods are not automatic but are on the basis of each person's need.

John Bercow: The hon. Member for Wakefield (Mary Creagh) is absolutely right. The Council of Europe convention on human trafficking was agreed in May 2005, and no fewer than 24 of the council's 46 members have signed up to it. Therefore, will the Minister tell the House what discussions she has had with the Home Secretary in respect of why the Government still feel unable to sign up to the convention, which would provide minimum standards of protection and treatment for all trafficked people?

Meg Munn: The ongoing discussions on this matter are very detailed. The UK took a lead and made human trafficking one of the key issues of our EU presidency. We are enormously concerned about it, and are consulting on our UK action plan. As I said in response to my hon. Friend the Member for Wakefield (Mary Creagh), we are looking at this issue. We consider every case on its merits, and women are given time to reflect. Our concern is that an automatic period may act as a pull factor in a way that would be unhelpful to real victims. However, there is no end date for the period in which the UK can sign up to the convention. That is under active consideration, and many other measures are in place to deal with the terrible problem of human trafficking. We are having great success in finding the people involved in it, stopping it happening, and dealing appropriately with the victims.

Business of the House

Theresa May: Will the Leader of the House give us the business for the week following the recess?

Geoff Hoon: The business for the week following the recess will be as follows:
	Monday 27 February—Progress on remaining stages of the Government of Wales Bill.
	Tuesday 28 February—Conclusion of remaining stages of the Government of Wales Bill—[Hon. Members: "Hooray!"]—I hope.
	Wednesday 1 March—Opposition Day [14th Allotted Day]. There will be a debate on dentistry followed by a debate on the future of cancer services. Both debates arise on an Opposition motion.
	Thursday 2 March—Second Reading of the Children and Adoption Bill [Lords].
	Friday 3 March—Private Members' Bills.
	The provisional business for the following week will include:
	Monday 6 March—Second Reading of the Police and Justice Bill.
	I should also like to inform the House that the business in Westminster Hall for the first two weeks in March will be:
	Thursday 2 March—A debate on lone parent employment.
	Thursday 9 March—A debate on violence against women.
	It may also assist the House to know that the Chancellor of the Exchequer proposes to deliver his Budget statement on Wednesday 22 March.

Theresa May: I thank the Leader of the House for giving us the business for the week after the recess. I am grateful that the Children and Adoption Bill has found a place in the business of the House for that week.
	The right hon. Gentleman and other hon. Members will have noticed that we will use our Opposition day on 1 March to discuss dentistry and the treatment of cancer patients in the NHS. I asked last week for a debate on dentistry, as did my hon. Friend the Member for Congleton (Ann Winterton), and the Leader of the House suggested that Members should raise the issue in today's debate on NHS inequalities. He was being somewhat disingenuous in saying that because the debate today not only covers the whole of the NHS, but will probably last for only two and a half hours. There will not be much time to talk about dentistry.
	In 1999, the Prime Minister gave a commitment that by the end of 2001 everyone would have access to an NHS dentist—a commitment on which he has failed to deliver. However, hon. Members may care to know that the Government have a radical and innovative answer to ending the queues of people waiting to sign up to a new NHS dentist. They are going to ban people from queuing and force them to apply by phone or post. We need a debate about the real answers to the problems, and we will give hon. Members that debate.
	On the issue of cancer patients and the use of Herceptin, and following yesterday's court decision—which revealed that, despite the comments by the Secretary of State for Health last autumn, the Government had not changed their policy—will the Leader of the House ensure that the right hon. Lady makes a statement to the House on Herceptin before the debate on 1 March?
	We waited a long time for it, but I was pleased to hear the Leader of the House announce the date of the Budget today. It is a pity that it was announced on Sky News before he could announce the date in this House. Talking of long waits, when will the education reform Bill be published?
	I realise that referring to the economy usually brings a torrent of statistics from the Leader of the House about inflation, interest rates and employment, but yesterday we saw the biggest rise in unemployment for 13 years, and there are serious underlying problems that need to be addressed, particularly the position of young people. Does he share my concern that over the past year there was a 28 per cent. increase in youth long-term unemployment; the number of economically inactive 18 to 24-year-olds has risen by nearly a quarter since Labour came to power; and that the number of young people who are not in education, employment or training has risen to 1.2 million? The Chancellor of the Exchequer said that he would not be satisfied until the Government had removed the scar of long-term unemployment from the face of Britain. Yesterday's figures show that he is failing to achieve that goal, so will the Leader of the House make time for a debate on youth long-term unemployment?
	Finally, on a day when a review of the work of the Electoral Commission has been announced, I note that the Leader of the House has previously said that in order to engage people in the electoral process we should force them to vote by making it compulsory and by fining people who do not vote. Is that still his view, or has he now realised that the more people who vote at the next general election, the bigger the Conservative majority?

Geoff Hoon: I am grateful at least for the right hon. Lady's last, rather entertaining, comment. I suppose that Opposition Front-Bench Members have to live in hope, but that is all they will be living in.
	On the right hon. Lady's specific points, I see no reason at all why right hon. and hon. Members should not make contributions about dentistry in today's debate. I am sure that one of the things that they will want to do is to note the fact that the Government have recruited the equivalent of 1,453 more dentists to the national health service, which has contributed to a net increase of 1,100 dentists; that overall there are 4,000 more dentists in primary care since 1997; that we are in the process of agreeing a new contract that will enable committed NHS dentists to earn an average of £80,000 a year; and that a third of dentists are already working under those new arrangements. There is significant progress, over and above the difficulties caused—in case the right hon. Lady has forgotten—by the reduction in the number of places for trainee dentists under the last Government. We inherited that problem and have sought to tackle it.
	On the nonsense about queues and forcing people to register by telephone, I would have thought that in the 21st century the right hon. Lady might welcome the fact that it is possible to register by telephone rather than having to stand outside in a queue, but clearly the Conservative party is still looking backwards. I recognise that for some of its members the telephone is a new-fangled invention, but it is nevertheless one that most people in society have got used to using. I welcome the efforts of the right hon. Member for Witney (Mr. Cameron) to modernise the Conservative party; perhaps soon it will use the telegraph rather than the pigeons that are clearly part of its internal communication system.
	On Herceptin, I am sorry that the right hon. Lady raised the issue in the way that she did. Obviously, everyone has sympathy for those diagnosed with cancer and it is important that we try to ensure that the drug is made available, especially given the promising results of recent trials, but it is equally important that we have a proper process to determine how new drugs are used, and I would have thought that all Members would agree about that. It remains the case that once the drug is licensed it can be generally used, but before it is licensed the matter is for local decision. That remains the position, and I would have thought that Members would support and welcome it.
	We have made it clear that the education Bill will be published before the end of the month. I have set out that position before and I am delighted to repeat it.
	On the economy, the right hon. Lady is on rather weak ground when she criticises the Government about unemployment. We realise that the Conservatives are experts on unemployment—they created and fostered so much of it during their period in office. The truth is that since 1997, 2,341,000 new jobs have been created, filled by people who are working hard to contribute to the success of the country's economy—expressions that could never, ever have been used during the Conservative period in office. I would hope that, rising occasionally above party political rhetoric, the right hon. Lady might acknowledge that success and congratulate the Government on it.
	I have always made clear my personal support for compulsory voting. It seems a modest commitment to expect of citizens in society, but I recognise that there are many views in that debate. I am happy to contribute to them.

Wayne David: As my right hon. Friend represents a former coal-mining constituency, he will know of the great progress that has been made on compensation payments to former miners. However, the issue of surface workers has yet to be satisfactorily resolved, so may we have a debate on that important matter?
	As my right hon. Friend is in such a good mood, will he consider giving an extra day to the Government of Wales Bill?

Hon. Members: Oh no.

Geoff Hoon: I prefer not to be drawn further on my hon. Friend's latter question, but he raises an important point about compensation payments. The Government have provided enormous funds to ensure that those harmed as a result of their experience of working in collieries are provided with compensation, although more work remains to be done to ensure that the final payments are made. Certainly, I recognise that there is an outstanding issue in relation to surface workers. I will ensure that my right hon. Friend the Secretary of State for Trade and Industry—who, incidentally, has just answered questions—will contact my hon. Friend with the details of this matter.

Nick Harvey: Will the Leader of the House make time for a debate on the future of the Post Office card account? Is he aware that there is very great concern in many parts of the House about the news that it will cease in 2010—not only the fact of that, but the manner of it as well? Is he further aware that although the Government argue that it was always known that the card account would be temporary, the Under-Secretary of State for Work and Pensions, the hon. Member for Warwick and Leamington (Mr. Plaskitt), said yesterday in Westminster Hall:
	"Of course, it is a temporary arrangement"—
	but if we had told people that at the beginning, it—
	"would have been interpreted as . . . a barrier to . . . taking up the account."—[Official Report, Westminster Hall, 15 February 2006; Vol. 442, c. 496WH.]
	So it seems to me that he has blown the gaff.
	We need such a debate not only for the sake of the 4.3 million people who have those accounts and rely on the convenience that they bring, or, indeed, because of the £1 billion a year that the contract is worth to the Post Office, but—this is a very immediate point—because sub-postmasters who have reached retirement age who want to sell their businesses now discover that, as a result of that major blow, the business itself has a much smaller value and they are now struggling to sell. It is a very important issue and I urge the Leader of the House to make Government time available to debate it.
	Will the right hon. Gentleman also find time for a debate on local government reorganisation, as contradictory signals are coming from the Government about their intentions, about the time scale and about the process—not least from the Deputy Prime Minister, as we heard yesterday?

Geoff Hoon: I do not know whether I am supposed to welcome the hon. Gentleman to his new responsibilities. Perhaps his hon. Friend the Member for Somerton and Frome (Mr. Heath) is out in the country campaigning for the write-in vote that I thought should be required of such an outstanding candidate for the leadership of the Liberal Democrat party, but we are all sorry that he is not here to receive our continuing support in his efforts to lead the Liberal Democrats.
	The Government have always made it clear that the Post Office card account was an interim arrangement. I hope that all right hon. and hon. Members will accept that it is an arrangement whereby those who want to continue rightly to use their local post office to receive a range of benefits can do so. Between now and the end of the arrangement in 2010, it would clearly be possible—pilot schemes are already under way—to allow people, having learned from the experience of using a Post Office card account, to use many of the similar accounts made available by the Post Office. They operate on exactly the same basis as the Post Office card account and will enable them to continue to receive benefits that way. That seems a wholly sensible and straightforward arrangement, and it will allow post offices to continue to receive the same level and quality of business as they enjoy under the present arrangements.

David Taylor: We have heard the happy news from Opposition Members of the flurry of babies that have arrived, but may we have a debate in Government time on the contrasting attitudes in the Chamber to the family-friendly policies that have been introduced? Apparently, the Leader of the Opposition is on paternity leave, but someone very like him was seen in the voting Lobby yesterday. Perhaps we can find out whether personation has taken place. Among Government Members, we are seeing the use of family-friendly policies affecting those with coming babies and upcoming retirement in that, according to the TV bulletins, job sharing and hot desking are taking place on a grand scale in Downing street.

Geoff Hoon: I am trying to work out which part of my hon. Friend's observations has anything to do with me. I will probably resist a running commentary on the various issues that he has raised, but the Government are certainly committed to family-friendly policies. I am delighted that the right hon. Member for Witney (Mr. Cameron), whom I should congratulate on the birth of a child, has been converted to the cause of paternity leave. We all know that he voted against the provision when it came before the House, but we always welcome a conversion, and we seem to be welcoming a conversion of large parts of the Conservative party to Labour policies. Long may it continue.

David Heathcoat-Amory: The Leader of the House will know that the press and the public are excluded from the weekly meetings of the European Scrutiny Committee. The Committee asked to meet in public during the past Parliament, but the then Leader of the House did nothing to change Standing Orders to allow that. What is the right hon. Gentleman's attitude towards openness and transparency, or is this another issue on which the Government lecture everybody else—in this case about the need for public access—and then do nothing to alter our parliamentary procedures to permit it?

Geoff Hoon: I have not received any specific request from those involved in European scrutiny during this Parliament, but it is something that I will look at carefully. As the right hon. Gentleman will be aware, there are proposals from the Modernisation Committee to look at the way we scrutinise European legislation. Those proposals are under consideration, so perhaps we can have a fuller discussion once they have been published.

Keith Vaz: May I draw my right hon. Friend's attention to early-day motion 1654, which deals with the siting of three mobile phone masts outside St. Joseph's Catholic church in Evington?
	[That this House notes with concern the construction of three telecommunication masts outside St. Joseph's Church, Leicester; calls on the companies building telecommunication masts to work together to reduce the number requiring construction; acknowledges that since the Stewart Report, published over five years ago, there have been significant advances and changes to mobile telecommunications technology; urges the Government to commission further research into the effects on health of telecommunications masts; and calls on the Government to carry out further consultations.]
	As a result of that decision, the church is to lose the possibility of having a children's nursery because parents are very concerned about the effects on their children's health of having those masts so close to the church and its hall. Can we have a debate on the Stewart report and consider introducing guidelines so that mobile phone operators are able to share one site and mast, rather than creating three?

Geoff Hoon: I have now had the opportunity of reading early-day motion 1654. My hon. Friend has set out, with his usual commendable clarity, the concerns of the people in his constituency who are affected. I think that he probably made his point in the course of his question.

Nicholas Winterton: The Leader of the House will be aware that there is huge opposition in England and Wales to the restructuring of police forces. The so-called consultation, which has been an utter fraud and charade, ends in a few days. When that period ends, will the Leader of the House arrange for a debate on the subject in the House? Is he aware that Bernard Hogan-Howe, the chief constable of Merseyside, with which Cheshire is to be merged, has stated that if the merger goes ahead the people of Cheshire will have huge resources transferred to Merseyside, and Cheshire's council tax will increase dramatically? Is that not reason enough for a debate in this House?

Geoff Hoon: The hon. Gentleman talks about huge opposition. I am certainly aware that there is some opposition. There is always opposition to this kind of change, which necessarily affects, in some cases, traditional boundaries and, in others, boundaries established for a number of years. I am sure that the hon. Gentleman would recognise that we cannot simply say that there will never be any change in the organisation of our police forces. Indeed, the organisation of those forces throughout the country has been in a steady process of evolution over many years.
	A proper subject for debate is the recommendation by very senior police officers—after all, the proposals come from a committee of the Association of Chief Police Officers—that there should be a reorganisation to ensure that police forces throughout the country are equipped to deal with the challenges that they face in the 21st century. I would be much more interested to hear from the hon. Gentleman and other Members who raise this issue why the Government should reject the advice from senior police officers that they need a reorganisation, rather than them simply making an argument based on traditional boundaries and a traditional way of doing things.

Alan Whitehead: Will my right hon. Friend find time for a debate on the co- ordination of the contents of Government reviews? I am sure that he will be aware, for example, of the publication two days ago of the waste review, which proposes a threefold increase in energy from waste between now and 2020—a fact that appears to be wholly absent from the considerations of the energy review, which is, at precisely the same time, considering energy supply up to 2020.

Geoff Hoon: My hon. Friend raises an important issue. A constant challenge for Governments organised on a departmental basis, and indeed any organisation that operates in that way, is to ensure that decisions taken in one part of the organisation are consistent with decisions taken elsewhere. This Government have spent a great deal of time and effort ensuring that there is co-ordination across government, improving cross-cutting efforts by different Departments. I recognise that there is still more work that we can do in that respect to achieve the ambition that my hon. Friend rightly sets out.

Peter Robinson: Will the Leader of the House arrange for time for discussion in this place of the facilities for Members, in particular the roll-out of IT equipment? I understand that after the allocation of equipment to new Members, existing Members are having it distributed in alphabetical order, and we are only at "C" at present, with some Members whose surname begins with "C" still not having had their equipment delivered to them. Those of us at the tail end of the alphabet will be more interested in pension arrangements than IT equipment by the time it is our turn.

Geoff Hoon: The hon. Gentleman makes his point with characteristic style. I was not aware that the process was going so slowly, but I shall certainly investigate and write to him once I have found the answer.

Helen Goodman: I know that the Leader of the House is committed to having more women Members of Parliament, but may I suggest one practical step that he might take to make Parliament more family-friendly? I read in the newspaper that he is considering shortening the summer recess. Before he does that, will he ensure that it still fully covers the school holidays? There is a problem with the next recess as I find that at Easter my children's school holiday overlaps with the recess by only a week. That may not be a significant problem for him, but for my nine-year-old daughter it is.

Geoff Hoon: I assure my hon. Friend that it is also a significant factor in the Hoon household, so I take her point very seriously. I have to say, however, that most of the criticism directed at the House is not that we are shortening the summer recess, but that we have far too long a summer recess. I recognise that that has provided significant opportunities for right hon. and hon. Members not only to spend more time with their families, but, crucially, to spend more time in their constituencies. That is something that we need to bear in mind. I assure my hon. Friend that the question of summer vacations is taken into account as we look at the dates for parliamentary sittings, but I also draw to her attention the consistent complaints from our Scottish colleagues that the summer recess very rarely takes account of Scottish summer holidays, so it cannot be an exact process that will satisfy everyone.

Andrew Rosindell: I hope that the Leader of the House has had time to read early-day motion 1637, which I tabled, regarding the Falkland Islands, following the hostile remarks of the President of Venezuela only a week ago.
	[That this House completely rejects the suggestion that the UK should hand over the Falkland Islands to Argentina made by Venezuelan President, Hugo Chavez, on 9th February; believes that all matters relating to the Falkland Islands, especially sovereignty, are issues concerning the Falkland Islanders and the British Government alone; notes the illegitimacy of the Argentine claim on the islands; and urges the Government to rally round these loyal subjects of the Crown whenever their sovereignty is questioned and to declare that the Union Jack will permanently fly above Port Stanley.]
	Will the Leader of the House find time for a debate in the House not only on the defence of the Falkland Islands, but on all British territories overseas?

Geoff Hoon: As someone who has had the privilege of visiting the Falkland Islands on a number of occasions, I recognise the hon. Gentleman's point. I hope that he will forgive me, but I have not read the early-day motion that he mentions. However, I can hazard a guess as to what it contains, and obviously I strongly support the continuation of the Falkland Islands as part of this country's heritage. It is something that we maintained absolutely as a priority in government, and we will continue to do so.

Gwyn Prosser: Will my right hon. Friend find time for a debate on surplus school places and the way in which Conservative county councils such as Kent seem arbitrarily and unfairly to be targeting schools in deprived and low-income areas? Such a debate would allow us to expose the reasons why Kent has suddenly singled out Dover and said that it wants to close down St. Radigund's school, Melbourne school, South Deal school and St. Joseph's school in Aylesham, against the wishes of people in those areas.

Geoff Hoon: My hon. Friend raises an important issue and one that clearly directly affects his constituents. I am sure, his having raised it in the way that he has today, that notice will be taken by Kent county council.

Roger Gale: On 1 February, the propaganda unit at the Treasury, the Government news network, published the headline "Primarolo Hails Success of Flexible Tax Credit System". At the end of the month, by the Paymaster General's own figures,
	"around 44,000 disputed overpayments were awaiting a decision."—[Official Report, 14 February 2006; Vol. 442, c. 1849W.]
	Each and every one of those disputed payments represents misery for a family with young children. Will the Leader of the House ensure that, when the Chancellor of the Exchequer makes his Budget statement on 22 March, instead of singing his own praises he addresses the 44,000 families who are living in fear?

Geoff Hoon: I am sure that the hon. Gentleman was referring in his opening remarks to hard-working civil servants serving the country with absolute impartiality and objectivity in the information that they make available. I am sure that that is what he intended to say, at any rate.
	We all recognise that there have been difficulties with the implementation of tax credit arrangements. That is why such effort has been put into ensuring that the system operates fairly and efficiently—and for the great majority of people, that is indeed the case. The system provides opportunities and financial support for families that was simply not previously available. Crucially, it also helps very many single-parent families back into the labour market. That would not have been possible without the availability of tax credits. I recognise that more work has to be done to ensure that the system can in particular respond quickly to the sudden and dramatic changes that affect people in their daily lives—that is the reason for the difficulties that have arisen—and we will continue to monitor that.

Jim Devine: I do not know whether my right hon. Friend has had a chance to look at early-day motion 1661, which is in my name and that of my hon. Friend the Member for Dundee, West (Mr. McGovern), and which states:
	[That this House congratulates the Bishop of Dunkeld, Bishop Vincent Logan on the Silver Jubilee of his episcopal ordination; notes that Bishop Logan was ordained Bishop of Dunkeld in the Cathedral Church of St Andrew, Dundee on 26th February 1981; further notes that he was educated in Bathgate, Blairs and Drygrange and ordained to the priesthood in the Archdiocese of St Andrews and Edinburgh in 1964 and that he served Episcopal Vicar for Education in the Archdiocese of St Andrews and Edinburgh; further notes Bishop Logan's continuing interest in education and in the formation of candidates for the priesthood; thanks Bishop Logan for his hard work in the Diocese of Dunkeld and beyond; and wishes Bishop Logan many more years of service.]
	It congratulates Bishop Logan on his ordination 25 years ago as a bishop in Scotland. It is his silver jubilee next week, and he is a well known and respected figure in Scottish society. Will my right hon. Friend join in with the congratulations?

Geoff Hoon: I am happy to join my hon. Friend in offering congratulations and grateful to him for telling me the subject matter of his early-day motion, as there seems to be a disturbing, recent trend of assuming that I have read every one of them.

David Howarth: I hope that the Leader of the House has had a chance to read a letter in The Times today from six professors of law at Cambridge university, expressing their concern about the extraordinary powers granted to the Government by the Legislative and Regulatory Reform Bill, which is now widely known as the "Abolition of Parliament Bill". Will he take steps to rescind the decision of the House last Thursday not to consider the Bill in a Committee of the whole House but to take it upstairs? Surely, given the Bill's massive constitutional importance and the seriousness of what part 1 does to the House's powers, all Members should have the opportunity to discuss it in detail on the Floor of the House.

Geoff Hoon: I know that the hon. Gentleman is on temporary, sabbatical leave from the university of Cambridge. We are delighted to have him here for a relatively short time while he represents the people of Cambridge. I hope that he did not stimulate that letter in The Times from his former colleagues in the law faculty at Cambridge university. I know that he is a distinguished lawyer and anxious to get back to academic life as soon as possible, but before he does so he will of course have the opportunity to debate the Bill in Committee in detail, and we look forward to his observations.

Sally Keeble: Is my right hon. Friend aware that a report is due out tomorrow of a major inquiry by Lord Carlile into the outrageous use of restraint, isolation and strip-searching of children in custody, which follows the death of a teenager in custody? Will my right hon. Friend ensure that there is a debate on that important subject?

Geoff Hoon: I have not yet seen the detail of the report, but from my hon. Friend's description, it obviously raises very important issues. I am sure that there will be opportunities to discuss it on the Floor of the House.

Bernard Jenkin: Does the Leader of the House not feel the slightest discomfort at the Government's committing a major deployment of troops to Afghanistan without any major debate in the House? May I suggest that he entertains seriously a request for a debate on Iran, which is contributing to the difficulties in Afghanistan? Is not it time that the Government held, in Government time, a full day's debate on the situation across the entire middle east, including Iraq, Iran and Afghanistan, while we consider the very serious matter of this major deployment?

Geoff Hoon: The hon. Gentleman knows full well that we have regular defence debates. Although they are given particular titles, the underlying arrangements have never changed, whereby right hon. and hon. Members can contribute across the range of defence issues. That has always been the practice. Debates on defence take place more regularly than those on most other subjects. There was an opportunity for discussion in the Chamber when my right hon. Friend the Secretary of State for Defence made a statement on the deployment to Afghanistan, so I do not accept that there are no opportunities for Members to raise those issues. They are important and are discussed on a regular basis.

Martin Salter: There can hardly be a Member in this House whose constituents, or at least some of them, have not been disturbed, harassed or, in extreme cases, threatened by the activities of Travellers. In Reading, we recently lost an entire week's worth of cataract operations because of a Travellers' encampment outside an NHS treatment centre. Given the wide disparity in approaches to that problem by police forces and local authorities, does the Leader of the House agree that there is a strong case for Ministers to come to the Dispatch Box to take part in a debate aimed at providing more efficient and tougher action in defence of the law-abiding community?

Geoff Hoon: I know that in my constituency the issue causes enormous distress and anger among local people. That is why the Government have strengthened the law on trespass and ensured that local authorities have the power to take swift action. I can only encourage local authorities to use the full powers that the Government have made available.

Elfyn Llwyd: May I draw the attention of the Leader of the House to motion No. 49 on today's Order Paper, which has been tabled by the right hon. and learned Member for Rushcliffe (Mr. Clarke) and me, among members of five political parties in the House? The motion calls for the setting up of a Select Committee of seven Privy Councillors to look into the events and Government policy leading up to the conflict in Iraq and its immediate aftermath. Given that the motion is signed by no fewer than 155 right hon. and hon. Members across the House, is not it time to debate that matter urgently in Government time?

Geoff Hoon: I am surprised to hear the hon. Gentleman suggesting by implication that there has somehow not been a thorough investigation of circumstances leading to the conflict in Iraq. There has been a series of reports, both within the House and beyond it. I have to say that the conflict has been investigated probably more than any other in history.

David Chaytor: Shortly before he took advantage of the Government's policy on paternity leave, which he had voted against, the Leader of the Opposition made an interesting proposal to abolish the royal prerogative. Given that nobody, not even the royals, appears to be opposed to the proposal, would it be possible to have a debate so that we could find ways of speedily implementing it? Would such a debate not also give us an opportunity to discuss other aspects of our constitution and progress on reform, not least of the House of Lords?

Geoff Hoon: I am delighted that the right hon. Member for Witney (Mr. Cameron) is examining a range of constitutional issues. As far as I can recall, we have never heard such a suggestion before from the Conservative party, so it is useful. Perhaps the Conservatives are recognising that they are in for a further and prolonged period of opposition, because those matters were never raised while they were in government—a point I have made directly to the right hon. and learned Member for Rushcliffe (Mr. Clarke), who has been appointed to have responsibilities in that area.
	My hon. Friend referred to the royal prerogative, linking it to the royal family. He will know, of course, that the royal prerogative is exercised by Ministers. Most constitutions have arrangements that allow for ministerial discretion. Indeed, most constitutions would say that those discretions are a necessary part of the process of government. Although it is important that we continue to discuss the extent of those arrangements, simply saying that it is possible to abolish the royal prerogative is a rather simplistic approach to a complicated subject.

George Young: May I thank the Leader of the House for responding positively to my business question last October by visiting Andover in my constituency earlier this week? It was much appreciated. On Tuesday, the Government avoided serious embarrassment by allowing a free vote on what had hitherto been a Labour party manifesto commitment. Would it not make sense to build on that important reform by having a similar dispensation for the education reform Bill?

Geoff Hoon: I repeat my thanks to the right hon. Gentleman for his hospitality in his constituency. I had an extremely interesting and illuminating visit. I hope that I shall not be required to visit every constituency to which right hon. and hon. Members are gracious enough to invite me, but I found the visit very interesting.
	As for the free vote on smoking, I should have thought that the right hon. Gentleman would congratulate the Government on delivering more than their manifesto commitment. Governments are usually criticised if they deliver less than their manifesto commitment. On this occasion, we delivered more than we promised the electorate, which seems a wholly sensible arrangement.

Gordon Prentice: May we have a debate on the honours system? In 2004, the Public Administration Committee made a number of wide-ranging recommendations about getting rid of knights, dames and name-changing honours, but all that was shelved. There is growing concern that the system is open to abuse and that people are, in effect, buying honours. Is it not time that we had an early debate on the matter?

Geoff Hoon: I am sorry that my hon. Friend has not given credit for the way in which the Government have opened up the process. We have ensured a great deal more transparency in the honours system and that many ordinary people can benefit from honours in recognition of the considerable service that they provide to the community, which is often unpaid and done on a voluntary basis. I should have thought that he would support an arrangement whereby we recognise the contribution that individual citizens make to the way in which our society works.

Peter Bottomley: In social security upratings, there is something that is normally missed because neither the Government nor the previous Government have changed it. I refer to the anomaly whereby people who have state pensions in this country do not receive upratings for inflation if they go to Canada, but do if they go to the United States. If they go to South Africa or Zimbabwe they do not, but they do in many other countries in Africa. It is time that Parliament had a debate to see whether fairness can be brought on that account.

Geoff Hoon: The hon. Gentleman is referring to long-standing arrangements put in place by the Governments of the respective countries. They have been in place for a very long time, under not only this but previous Governments. It would require a great deal of careful thought before we could replace such long-standing understandings.

Brian Jenkins: My right hon. Friend will be pleased that I am not going to mention my early-day motion on Sunday trading, because I know who to go to on that and which Department to tackle. However, can he find time for a debate, and I would be grateful to know who is the relevant Minister, because I do not know who to tackle, on the costs and effects on the delivery of joined-up government services of the proposed simultaneous reorganisation of the fire, police and ambulance services, primary care trusts, education, and local government in my constituency?

Geoff Hoon: I am sure that my hon. Friend does know who to go to, but I appreciate that he is trying to save on postage costs by not contacting a number of my right hon. Friends. I recognise that there is a requirement for reorganisation in a number of areas—I am tempted to say that he has mentioned all of them—but it is important that such changes continue to deliver effective services to his constituents, my constituents and people across the country. Those reform processes are a necessary consequence of the significant investment that has been made in each of the services that he mentioned. The country rightly expects more money to be made available for those services, but it also expects that money to be used efficiently, wisely and successfully. That is why those reorganisations are necessary.

Peter Bone: Slavery has been abolished in this country for a very long time, but young women are being trafficked from central Europe to this country to be sold as sex slaves, and they are working in the most appalling conditions. However, the Government have failed to sign the European convention on action against trafficking in human beings. I believe that that is a fit subject for a debate.

Geoff Hoon: This is an important issue and the Government are determined to stamp out that vile practice. I am grateful to the hon. Gentleman for raising the issue.

Paul Flynn: When may we have a debate on the world shortage of diamorphine, which means that anyone dying in a third-world country has only a one in 20 chance of gaining access to that vital pain reliever? Would it not be more sensible to employ our troops in ensuring that the Afghan farmers can be licensed to use their poppy crops to supply the world with diamorphine, rather than using them to destroy the only means of livelihood for farmers in Helmand province, which will lead to great danger for our troops and will not add to the world production of diamorphine?

Geoff Hoon: I was not aware that there was a shortage of diamorphine. I recognise that, in some parts of the world, the cost of the drug will probably be beyond the means of many people who would benefit from its use. I am not sure, however, that I agree with my hon. Friend's observations about Afghanistan. Far too much of the Afghan economy is already based on the production of opium, and it is vital that we persuade farmers there to adopt alternative livelihoods so that, in the future, Afghanistan is not a country that is totally dependent on the production of a harmful drug.

Michael Jack: This week, we have seen the first operation of the office of the alternative Prime Minister, with the Chancellor of the Exchequer making speeches on Government security policy. Bearing that in mind, and given the job share that is taking place between No. 11 and No. 10 Downing street, what alterations will the Leader of the House make to the operation of Prime Minister's Question Time to enable us, where appropriate, to question the alternative Prime Minister?

Geoff Hoon: I see that Opposition Members are in a light-hearted mood as they approach the recess. They are providing us all with regular entertainment. My right hon. Friend the Chancellor of the Exchequer is fully engaged in his responsibilities. Inevitably, as one of the longest-serving and most successful Chancellors that this country has ever had, he is necessarily involved in looking across the board at the impact of our very successful economic policies, and it is right that he should do so. I have indicated to the House that he continues to concentrate on the economy, and he will do so when he makes the Budget statement in due course. I am sure that the right hon. Gentleman would want to congratulate my right hon. Friend on his successful stewardship of the economy over such a long period.

Jim Cunningham: May we have a debate on the reorganisation of the health service in the midlands, specifically the west midlands? Earlier, my right hon. Friend said that more money should be provided, but that people should receive value for money. If we were able to hold a debate on the reorganisation of the health service in the west midlands, should not Members be allowed to test the relationship between restructuring, value for money and costs?

Geoff Hoon: I am sure that, once any proposals for the reorganisation of the health service in the west midlands, or, indeed, any other part of the country, are decided, there will be opportunities for my hon. Friend and all Members to have their say. I emphasise that by 2007–08 the Government will treble the amount of money spent on the health service. Alongside that, it is necessary to ensure that that money is spent successfully and effectively, and provides value for money for taxpayers—the people who contribute to that excellent health budget. I am sure that my hon. Friend would agree with that approach.

Richard Younger-Ross: Will the Leader of the House ask the Deputy Prime Minister or one of his Ministers to make a statement on noise and disruption caused by construction works, particularly overnight working, the powers of the local authority to control that through planning and environmental health measures, and perhaps the moral duty of contractors and developers such as Asda, which is building a supermarket in my constituency, to compensate people kept awake at night because of the necessity of overnight working?

Geoff Hoon: I recognise that construction can cause temporary disruption to people's lives, and no doubt the hon. Gentleman has raised the matter directly with the company concerned. I have sympathy for those affected, but I am sure that he would welcome the employment prospects provided by construction and the opportunities provided by a new supermarket for employment in his constituency.

Geraldine Smith: Now that we have banned smoking in all enclosed public places and private members' clubs, is it not hypocritical that the House is exempt and that Members will still be able to smoke in the Smoking Room? What does my right hon. Friend propose to do about that?

Geoff Hoon: I am used to answering questions on matters for which I have absolutely no responsibility, but I recognise the importance of that matter to the outside world, following the votes in the House the other day. It is my strong personal view that although it is not formally subject to the legislation, the House should apply the decision that we have taken for other people to our own arrangements here. I look forward to suggestions as to what the Smoking Room will be called in future.

Julian Lewis: Through the Leader of the House, may I express my thanks for the great courtesy shown by the Downing street police and staff at the door to a group of second world war veterans handing in a letter yesterday to the Prime Minister on behalf of the widow of the late Lieutenant Norbury, who was wrongly denied a war pension? I hope that my meeting on the subject with the veterans Minister this afternoon will lead to a positive outcome.
	May we have a statement or debate on the way in which criminal sentences are described to the public when they are imposed? Last week we saw a great deal of publicity that Abu Hamza had been sentenced to seven years in prison, whereas the reality is that he will serve three and a half years. Would it not be more honest to tell the public that people have been sentenced to a range from three and a half to seven years, so that people will not be disillusioned when they see that those whom they thought had deservedly been put away for a long time are out on the streets all too soon?

Geoff Hoon: The hon. Gentleman raises an issue that is regularly discussed in the House and with my right hon. Friend the Home Secretary. Although my right hon. Friend would accept that there are various circumstances that can lead to a reduction in a sentence, those reductions are not automatic. They are a necessary part of our sentencing system. They provide proper control over prisoners in prison, and although the hon. Gentleman is right to point out that some people are not aware that discounts are available for good behaviour, the great majority of the public are aware of that. Indeed, in my experience most people assume that the discounts are rather greater than they are in reality.

Barbara Keeley: In the last round of post office cuts, more branches were closed in Worsley than in any other constituency in Greater Manchester. Now there is a threat to one of the remaining branches in Roe Green. A series of management problems have led to post office counter trading in an otherwise empty shop, and my constituents rightly fear that that is the forerunner of another closure. In view of that, will my right hon. Friend consider a debate on the accessibility of post office branches now and in the future?

Geoff Hoon: My hon. Friend has made her point, I think, but I recognise the importance of post office counters to people throughout the country, particularly to those who cannot travel further afield for the range of services that the post office provides. I know that the Post Office keeps the matter under regular review, and it is of enormous importance to our citizens and our constituents.

Nigel Dodds: May I add to the right hon. Gentleman's reading list by drawing to his attention early-day motion 1499 on abuse of the elderly, which the motion rightly describes as a national shame?
	[That this House condemns the abuse of older people as a national shame; supports the Help the Aged campaign, which is being taken forward in partnership with Action on Elder Abuse, to raise awareness of abuse and increase recognition that all of us need to take responsibility for putting a stop to the abuse of older people; believes that older people have the right to live free from fear and harm; urges immediate action to prevent and tackle elder abuse; and calls for improved mechanisms to address elder abuse through more effective regulatory systems and law enforcement, vetting and barring of health and social care workers and increased access to advocacy and support for people affected by elder abuse.]
	The elderly have the right to live free from fear and harm, and an early debate would allow us to highlight the important issue of abuse of the elderly in our society, particularly attacks on the elderly, which many hon. Members know are increasing weekly. I should be grateful if the Leader of the House spared Government time to debate this important matter.

Geoff Hoon: I am grateful to the hon. Gentleman for raising an issue that is important throughout the country. There can be no excuse for such appalling attacks. He has highlighted the issue in his early-day motion, and we shall continue to watch it carefully. I assure him that the Government do not take the matter lightly. We want to see it dealt with and we want the appropriate authorities to take appropriate action.

Lindsay Hoyle: My right hon. Friend is aware that there is great pressure on home owners, with a potential rise of 25 per cent. in energy prices. Has not the time come for someone who buys a new home to pay no VAT? People who renovate their homes to try to create warm homes have to pay full VAT. This anomaly needs to be dealt with. We should encourage people to maintain their properties and keep them at a good standard, so let us remove or reduce the burden of VAT.

Geoff Hoon: I take that as an early Budget submission. I am sure such issues will be properly considered by my right hon. Friend the Chancellor once the Budget has been set out to the House.

Andrew MacKay: I feel sure that the Leader of the House will recognise that the speech today by the chief executive of the RAC has made a significant contribution not just to road safety but to improving our environment. Mr. King pointed out that we suffer a severe road sign overload. Can the right hon. Gentleman give me some assurance that when the House returns after the recess a Minister will make a statement on changing the regulations so that there is better planning guidance to local authorities and to the Highways Agency?

Geoff Hoon: I have seen press accounts of the speech and recognise that the chief executive of the RAC raises an important issue that affects road safety across the country. Obviously there is a balance to be struck between the need to ensure proper communication of information to motorists in order to provide for their safety, while not overloading their understanding at a time when they are concentrating on driving safely. I am sure that the speech will be considered carefully by my right hon. Friend the Secretary of State for Transport.

Points of Order

Owen Paterson: On a point of order, Mr. Speaker. I am grateful to you for allowing me to make a point of order, of which I have given you prior notice.
	In recent years, the Government have been encouraging—some would say bullying—benefit recipients to take benefits through direct payment to banks or through a Post Office card. I was involved in that debate and I cannot remember at any stage receiving a letter or reading anything in Parliament to say that the card was anything but permanent. I even had a constructive meeting—I took one of my postmasters—with the Minister for Pensions Reform, who was then the Minister responsible, and I cannot remember anything being mentioned to suggest that the card was anything but permanent.
	That was until yesterday, when we had a spirited debate in Westminster Hall and the Under-Secretary of State for Work and Pensions, the hon. Member for Warwick and Leamington (Mr. Plaskitt), whom I am delighted to see in his place, read out the contract between the Government and the Post Office in 2002. He said:
	"I am in the middle of a quotation"—
	he was speaking to the hon. Member for Brighton, Pavilion (David Lepper)—
	"and I must conclude it. It goes on:
	'The POCA is intended to be an interim step for Account Holders who will be encouraged by both Parties to migrate to Bank Accounts'"—[Official Report, Westminster Hall, 15 February 2006; Vol. 442, c. 495WH.]
	I do not think anybody in the country, apart from those who were privy to the contract, knew about that. There has been the most enormous deceit perpetrated on literally millions of benefit recipients. There are 4.3 million cardholders at the moment, and they took on these cards not knowing the facts.
	Incredibly, the Minister went on to say,
	"If . . . we had been actively saying, 'Of course, it's a temporary arrangement,' that would have been interpreted as yet another barrier to discourage people from taking up the account."—[Official Report, 15 February 2006; Vol. 442, c. 496WH.]
	It seems to me to be deceitful of the Government to have perpetrated this on millions of benefit recipients. The Minister was pressed to say that he would put the full contract in the Library. It says on page 441 of "Erskine May", under the heading, "Citing documents not before House":
	"A Minister of the Crown may not read or quote from a despatch or other state paper not before the House, unless he is prepared to lay it upon the Table."
	The Minister has quoted verbatim a selected piece from a Government document. That document is relevant to millions of benefit recipients and to the 14,400 post offices whose future is now in jeopardy. Could you please rule, Mr. Speaker, that the Minister, contrary to what he said in Westminster Hall, should place this vital document in the Library so that Members of this House and the citizens of this country can read it?

Mr. Speaker: I have studied the record of the debate to which the hon. Gentleman refers. "Erskine May" does indeed say that a Minister of the Crown must not quote from a state paper unless he is prepared to lay it upon the Table. However, "Erskine May" goes on to say that a document cited by a Minister ought to be laid upon the Table
	"if it can be done without injury to the public interest".
	In this case, the Minister stated clearly that most of the contract was "highly commercially confidential". However, I see no reason why the Minister could not place in the Library a copy of the document with any sensitive material removed.

Peter Bottomley: Further to that point of order, Mr. Speaker. Clearly a freedom of information application should get out of Government whatever other non-confidential discussions they had with the Post Office on this issue, outside of the contract. Would not it be more elegant if the Government, given the rightful fuss about this, volunteered to make such documents available without having to be pushed into doing so?

Mr. Speaker: I have ruled in this matter and I have looked at it in detail. I think that it is best that I say no more, because I believe that the hon. Member for North Shropshire (Mr. Paterson) is satisfied with my ruling.

John Hayes: Further to that point of order, Mr. Speaker. The Leader of the House was challenged on this matter two weeks ago at business questions, when he was asked to confirm that the original arrangement had been a temporary one. He said that it was not a temporary arrangement but an interim arrangement. I took the trouble of looking up the word "interim" in a dictionary, where it is defined as "temporary". The Leader of the House, inasmuch as he inadvertently described it inaccurately, may wish to correct the record in the normal way.

Mr. Speaker: I will not say any more on the matter.

Roger Gale: On a point of order, Mr. Speaker. You will have heard the exchange between the leader of Plaid Cymru and the Leader of the House in relation to item 49 of the remaining orders and notices and the reply given to the House by the Leader of the House. Item 49 is signed by 159 Members of this House from five parties, including eight Privy Councillors. I understand that you cannot interfere in the affairs of Government, but as the custodian of the rights of Back Benchers, I wonder if you could find it in yourself to invite the Leader of the House to your apartments and gently explain to him that this is a matter that the House considers very seriously. We want a Select Committee.

Mr. Speaker: It is what the House wants and it certainly may be what a number of Members in the House want. However, the hon. Gentleman knows that the Speaker cannot interfere in these matters, and it would be inappropriate for me to try to support the case of a number of Members in this House.

Alex Salmond: Further to that point of order, Mr. Speaker. The Leader of the House is in a very special position because he is a Government Minister but also has a wider responsibility, in terms of the rules of the House, to the whole House. The motion under discussion, in asking the Leader of the House to allocate time for it, gives him a particular difficulty, because it calls for an examination of Government policy and Government Ministers, and the Leader of the House, in his previous high office, was one of those Ministers. Does not that place the Leader of the House in the invidious position of having to judge whether to allocate time to an inquiry by a Select Committee of Privy Councillors, supported, as was said, by 159 Members of this House, which would inevitably involve an inquiry into his own actions? Is not that a difficulty and a conflict of interest?

Mr. Speaker: The hon. Gentleman has been a Member of this House for a long time. Not only this Leader of the House but other Leaders of the House have been in that difficulty, and the House has been able to live with it, as, indeed, have the Leaders of the House.

John Bercow: On a point of order, Mr. Speaker. I seek your guidance on a matter on which I have tabled parliamentary questions but on which the Government have thus far refused substantively to answer. It is a matter of the utmost importance. The facts, very simply, are these, and I am worried about them. Charles Munyaneza, who is a former Rwandan Government official suspected of the orchestration of the mass killing of civilians in Rwanda, has already been publicly exposed—it is not before the courts—as living in Bedford. It is not disputed that in 2002 the Government gave him unlimited leave to stay in this country. The international criminal tribunal on Rwanda, headed by the UN, has already indicated that it would provide to Britain all the evidence that it has on the man if Britain wishes to bring him to justice. What I want to know are two very simple things that the Government refuse to tell me—

Mr. Speaker: Order. I must stop the hon. Gentleman, because what he wants to know might be information that the Government have, but it is certainly not information that I am privy to. I noticed that he missed out in business questions, but perhaps he could try to raise the matter next time round. However, it is certainly not something that the Chair would rule on, and I must therefore stop him.

Owen Paterson: On a point of order, Mr. Speaker. May I thank you for your ruling, which was most helpful?

David Gauke: On a point of order, Mr. Speaker. Yesterday, my hon. Friend the Member for West Chelmsford (Mr. Burns) raised with you the case of a parliamentary question to which the answer was provided to a journalist before it was provided to him. This morning, we have heard, including from my right hon. Friend the Member for Maidenhead (Mrs. May), that the date of the Budget was announced and released to the press before this House was informed. Given that you are making inquiries in the case involving my hon. Friend the Member for West Chelmsford, would you also look at this matter as an example of how the Government are releasing information not to this House first, but to the press?

Mr. Speaker: I think that it is important that a Minister of the Crown comes to the House as soon as possible with that particular date. This has happened, and I see no breach of the rules in this case.The other matter that the hon. Gentleman raises is still subject to an investigation by me, and I will be getting back to the House.

ROYAL ASSENT

Mr. Speaker: I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified her Royal Assent to the following Acts:
	Racial and Religious Hatred Act 2006
	European Union (Accessions) Act 2006
	Equality Act 2006
	Terrorism (Northern Ireland) Act 2006
	Transport (Wales) Act 2006

BILL PRESENTED

Northern Ireland (Miscellaneous Provisions) Bill

Mr. Secretary Hain, supported by The Prime Minister, Mr. Chancellor of the Exchequer, Mr. Secretary Straw, Mr. Secretary Clarke, Secretary Alan Johnson and Mr. David Hanson, presented a Bill to make provision about registration of electors and the Chief Electoral Officer for Northern Ireland; to amend the Northern Ireland Act 1998; to make provision about donations for political purposes; to extend the amnesty period for arms decommissioning in Northern Ireland; and to make miscellaneous amendments in the law relating to Northern Ireland. Explanatory notes to be printed [Bill 131].

Social Security

Stephen Timms: I beg to move,
	That the draft Social Security Benefits Up-rating Order 2006, which was laid before this House on 25th January, be approved.

Mr. Speaker: With this it will be convenient to take motion 3 on the Order Paper:
	That the draft Guaranteed Minimum Pensions Increase Order 2006, which was laid before this House on 25th January 2006, be approved.

Stephen Timms: I am satisfied that the orders are compatible with the European convention on human rights.
	The uprating order will, as usual, increase most national insurance benefits by the retail prices index, which is 2.7 per cent., and increase most income-related benefits by Rossi, an index that excludes rent, mortgage interest, council tax and depreciation, which is 2.2 per cent.
	The Guaranteed Minimum Pensions Increase Order 2006 deals with contracted-out occupational pension schemes and guaranteed minimum pensions that accrued between 1988 and 1997 and provides for an increase of 2.7 per cent.

David Taylor: I declare an interest as a member of such a scheme, although I have not reached state retirement age and therefore would not benefit from the guaranteed minimum pensions element. Does the Minister believe that the RPI is still the appropriate measure for uprating the GMP element, not least because beneficiaries have a different index profile, in that they spend more of their income on heating and other elements of daily costs, which would significantly boost the RPI figure?

Stephen Timms: My hon. Friend has raised an interesting point. I think that the RPI is the right basis on which to proceed, but the national pensions debate is under way and he may want to raise that point in the discussion.
	The order adds nearly £3.5 billion to Government spending. It tackles poverty by helping those most in need and supports our ambitious programme to renew welfare and pensions. Since 1997, we have taken decisive measures to address the pressing problems that we inherited. Through winter fuel payments, free TV licences for over-75s and basic state pension increases, we have helped all pensioners. From April 2006, the basic state pension will be £84.25 for a single person and £134.75 for couples, which is a real-terms increase of 8 per cent. since 1997. By targeting extra resources on the least well-off, in particular through pension credit, we have taken nearly 2 million pensioners out of absolute poverty.
	The pension credit guarantee will rise in line with earnings so that even the least well-off pensioners can share in Britain's rising prosperity. From April, no single pensioner need live on less than £114.05 a week, and no couple need live on less than £174.05 a week. In 1997, many pensioners were living on £69 a week, which was a shameful legacy of poverty that we must never allow to return.

Graham Stuart: Is the Minister comfortable with the fact that, according to Government figures, about 1.5 million pensioners are not claiming their due pension credit? NGOs that specialise in looking after older people have suggested that the poorest and most in need are not getting the pension credit. Will the Minister re-examine his claim in that light?

Stephen Timms: We continue to be extremely active in promoting the take-up of pension credit. There has been a large increase in take-up since pension credit succeeded the minimum income guarantee, and it is clear that those who stand to gain the most from it are now overwhelmingly in receipt of it. The hon. Gentleman is right that a significant number of people—in particular, those who are entitled to the saving credit only—are not yet in receipt of it, which is why we have introduced a big programme of targeted mail shots and home visits to ensure that people take up their entitlement.

Nigel Dodds: The Minister has mentioned the winter fuel allowance. People are grateful for the £200, but it has been stuck at that level for six years. When will it be increased to take account of the RPI or inflation?

Stephen Timms: I cannot announce an increase in the winter fuel allowance. When the allowance was introduced, it was at a much lower level, and, as the hon. Gentleman said, people find it helpful.
	As a result of changes since 1997, we will spend some £10 billion extra on pensioners in 2006–07, almost half of which will go to the least well-off third of pensioners. If we had merely increased the basic state pension in line with earnings, the least well-off third of pensioners would be on average £30 a week worse off. Today, we are in an almost unprecedented position in which pensioners are no more likely to be poor than any other group in society. We have succeeded in breaking the historic link between being old and being poor, an achievement that I hope that hon. Members on both sides of the House will celebrate.
	We have made other important changes to pensions policy since 1997. We have set a framework within which there are personal pension products that are economic for people on low and medium incomes. We have improved the coverage of the state second pension, which includes carers for the first time and, through the Pension Protection Fund, we have provided protection for occupational defined benefit schemes.
	We must build on the progress so far and meet two significant challenges around pensioner incomes. First, demographic changes mean that by 2050 there will be two people of working age for every pensioner compared with 10 people for every pensioner 100 years ago. The current figure is about four. Secondly, we need to address the extent of under-saving. The Pensions Commission has calculated that nearly 10 million people are not saving enough for their retirement.

Philip Hollobone: I appreciate the nobility of the Government's aim of improving pensioner incomes, but does the Minister understand the concerns of thousands of pensioners in my constituency who see the system as a disincentive to save? The system also sends the message to the younger generation that they need not save because the state will look after them in their retirement.

Stephen Timms: I am glad that the hon. Gentleman recognises the nobility of the Government's aim and hope that he also recognises the nobility of the Government's achievement in breaking the historic link. The question of incentives for saving lies at the heart of the Turner commission report and the national pensions debate, which is currently under way. The report and the debate give us the chance to build a consensus for an enduring pensions settlement. That is our aim and I hope that the hon. Gentleman and other Opposition Members will be part of it. Consensus is very important, because we need a pensions settlement that will stand the test of time and not be pulled apart by successive Governments.
	Later this month, industry groups will present their alternatives to Lord Turner's national pensions savings scheme. On 18 March, which is national pensions day, more than 1,000 people will meet in six cities across the country to consider the choices and options in the Pensions Commission report. I look forward to welcoming Opposition Members to that programme and we will debate and scrutinise the different ways to achieve the objectives set out by the commission.

Anne Begg: The Minister rightly highlighted the Government's success in redistributing wealth to the poorest pensioners. Will he assure me that, whatever comes out of the discussions about the Turner report and the White Paper, the policy objective of ensuring that the poorest pensioners are the most looked after by the state will continue?

Stephen Timms: I can give my hon. Friend that assurance. It was a scandal that so many pensioners were on a means-tested benefit of £69 a week in 1997. We must not head in that direction, where a large number of pensioners were below the generally recognised poverty threshold. That will be a key criterion in our package of reforms, and I am sure that she has been encouraged by Lord Turner's comments about maintaining the pension credit.
	To meet the challenges of an ageing society and permanently eradicate poverty in retirement, we must address inequalities during people's working lives. That is why our record in tackling child poverty is so important; that is why we are committed to supporting families in work; that is why our welfare reforms and aspiration of an 80 per cent. employment rate are so important; and that is why we want to see a modern, active and inclusive welfare state.
	When I made my statement on today's benefit uprating to this House in December, the hon. Member for Eastbourne (Mr. Waterson) asked, in a slightly sceptical tone, about our proposals for welfare reform. As I said that we would, we set out in the Green Paper in January our ambitious and radical proposals for a welfare state that lets people move out of poverty rather than a welfare state that institutionalises dependency. We want a million fewer people to claim incapacity benefit, a million more older people to be in work and 300,000 lone parents to be able to come off benefits.
	The hon. Member for Runnymede and Weybridge (Mr. Hammond), whom I am delighted to see in his place this afternoon, welcomed the proposals and congratulated my right hon. Friend the Secretary of State on
	"grasping the nettle of incapacity benefit reform".—[Official Report, 24 January 2006; Vol. 441, c. 1310.]
	He pledged to support the proposals and to work towards a consensus.
	That is the consensus that we want to build. I hope that it will not be too long before Opposition Members finally have the grace to support the new deal, which is responsible for helping more than 1.5 million people into work. We will strengthen the new deal so that it offers learning agreements for teenagers in eight areas of the country, extends the new deal pilots to help lone parents back into work and pilots personal action plans for those unemployed for six months or more.
	For the sixth successive year, we will freeze non-dependent deductions to relieve the pressure on low-income parents who house their adult children, which will benefit some 30,000 benefit recipients. We want a welfare system that breaks down the barriers to opportunity and enables all those who can work to do so.
	Our "Age Positive" campaign has promoted the business case for age diversity in the work force. This year we shall legislate for the first time against age discrimination in the workplace. A new default retirement age will mean employers can no longer compel an employee to retire before the age of 65 without objective justification. In 2011, an evidence-based review will consider the possibility that the default retirement age should go altogether.

Peter Bone: I am concerned that an error appears to have built up over the years. The Secretary of State is required to review the increases—of course, pension credit has increased—but because a lot of money from the pension credit has not been taken up, it is sitting in a pot when it should have been distributed. Would it not be right to uprate the basic pension by more than inflation this year to take account of those millions, or possibly billions, of pounds?

Stephen Timms: I hope that the hon. Gentleman will welcome the fact that the basic state pension has been uprated well above inflation since 1997—by 8 per cent. in real terms. That is in sharp contrast to what his party did in government. There was no real-terms increase in the basic state pension between 1980 and 1987, except for a single year—the year in which VAT was added to fuel—in which it was increased by 50p a week on top of inflation. That year is vividly recalled by pensioners and, indeed, by us all. I hope that the hon. Gentleman will welcome the substantial real-terms increase in the basic state pension that the Government have brought about.
	In April, radical tax simplification on A-day will enable people to draw their occupational pension while continuing to work for the same employer. April will also see the first people benefit from the new state pension deferral option of a lump sum that could be worth £5,000, improving rewards for those who choose to delay taking their state pension even if they do so for only a short time.
	In tackling the pernicious poverty of the past, we have opened the door to lifelong opportunity and independence. We are laying foundations for a long-term pensions settlement and have delivered tailored, flexible support to help groups that were previously excluded from work to break out from dependency and realise their ambitions for the first time. We have given families the flexibility and resources to balance the demands of work with those of child care and to ensure that children get the best possible start in life.
	The standard rates of statutory maternity pay and maternity allowance have increased by just over 80 per cent. Those improvements complement others such as the increase of maternity leave to 26 weeks, the introduction of an additional period of 26 weeks' maternity leave after that and the introduction of rights to two weeks' paternity leave and pay as well as 26 weeks' adoption leave. It is good to see those opportunities being taken up by Opposition Members. We are giving parents greater choice in how they balance their work and caring responsibilities in the first year of their child's life. The Work and Families Bill will introduce a new entitlement to statutory paternity pay to enable a father to take time off work and receive statutory pay instead of his partner if she returns to work early.

John Bercow: I am grateful to the Minister for giving way, particularly because I have recently enjoyed a period of paternity leave.
	In a system that is both civilised and robust, we should always support the jobless but never subsidise the job-shy. As the Minister was focusing on those matters a few moments ago, what are the Government doing when uprating jobseeker's allowance to ensure that in the minority of cases when people repeatedly refuse reasonable offers of work, there is some stick as well as a carrot?

Stephen Timms: First, I congratulate the hon. Gentleman on the recent birth of his child. I am delighted that he was able to take up the opportunities that I described.
	Jobseeker's allowance is going up in line with Rossi, as I announced earlier. Of course, the hon. Gentleman is right that we need a good balance of rights and responsibilities. That approach is reflected in our changes and in the developments in the new deal, which are a good example of precisely the kind of balance that he is looking for. That is why I expressed the hope that his party might come to support the new deal before too long. It represents exactly the approach that he advocated.
	We have lifted more than 500,000 children out of relative low income since 1997. Tax credits are benefiting 20 million people, including more than 10 million children. The child tax credit, which will increase by earnings, benefits 6 million families. From April, the child allowance, the family premium, the disabled child premium and the enhanced disability premium for a child will all increase, which will directly benefit the least well-off families.
	Last week, my right hon. Friend the Secretary of State announced that he has asked Sir David Henshaw completely to redesign our system of child support. My right hon. Friend announced additional investment up to £120 million to stabilise and improve the performance of the Child Support Agency in the short term. By 2008 we will improve compliance rates, ensure that 200,000 more children benefit from maintenance payments, be on track to help lift an additional 40,000 children out of poverty and see a significant increase in the number of parents who receive the child maintenance premium. As my right hon. Friend made clear, Members will have the opportunity to make their views known to Sir David and his team and I hope that they will do so.

Jeremy Hunt: The Minister talked about tackling poverty among children. Is he aware that income poverty among disabled people is increasing? He will be aware that the take-up of disability living allowance is about 50 per cent. Does he think that that could be connected to the fact that the form to claim DLA is 51 pages long? Will he urgently look into whether that form can be simplified to increase take-up of DLA among a group for whom income poverty is increasing?

Stephen Timms: I hope that the hon. Gentleman will support the approach supported by his hon. Friend the shadow Secretary of State in the welfare reform Green Paper. At least 1 million people on incapacity benefits would like to be in work and the changes will help them to make that move. That includes those people who are on DLA, because the great strength of DLA is that it is available to people in work as well as those who are out of work. I do not agree with his figure, because we do not know until someone has completed the assessment process whether they are entitled to DLA. However, the number of people who receive DLA continues to increase, and has gone up again significantly over the past year. That reflects the efforts that we have made to ensure that people receive the benefits to which they are entitled.

Jim Sheridan: Will the Minister give way?

Stephen Timms: I apologise to my hon. Friend; I will not give way again.
	Our uprating measures maintain our commitment and continue our progress towards a fair and inclusive society of opportunity and independence for all. They support our programme of radical reform, balancing rights with responsibilities and offering everyone the opportunity to build a decent income in retirement. They also represent another big step away from the legacy of pernicious poverty that we inherited, and that we are determined should never return. I commend the orders to the House.

David Ruffley: We welcome this debate, and I am grateful to the Minister for setting out the Government's proposals on the uprating of social security benefits and guaranteed minimum pensions. We shall not oppose the proposals in the Lobby today.
	We welcome the extra benefits, but we cannot be satisfied with a welfare system that is increasingly being driven by mass means-testing. There was little in the Minister's statement today about the real need for reform. In his benefits uprating statement on 6 December last year, he said that the changes that he was announcing were in the context of
	"the Government's continued fight against poverty and our ambitious programme to renew the welfare and pensions systems."—[Official Report, 6 December 2005; Vol. 440, c. 741.]
	In October 1996, millions of people heard the Prime Minister famously say:
	"By the end of a five-year term of a Labour Government: I vow that we will have reduced the proportion . . . that we spend on the welfare bills of social failure . . . This is my covenant with the British people. Judge me upon it. The buck stops with me."
	At least the Minister for Employment and Welfare Reform, the right hon. Member for Barking (Margaret Hodge), who is not in her place today, recently had the honesty to admit that the Government had done "sweet nothing" to tackle this problem until recently. The Conservative Opposition will make constructive proposals finally to get to grips with a social security system that is tragically wasting too much human potential and writing off too many people's lives.

Anne Begg: The Conservatives constantly criticise means-testing and targeting, both of which effectively give more money to those who are poor. How on earth can any political party say that it is going to end poverty if it is also going to abolish means-testing?

David Ruffley: If the hon. Lady looks at Hansard tomorrow, she will see that I referred to "mass means-testing". Of course, any welfare system will require an element of means-testing—[Hon. Members: "Ah!"] That is self-evident. Our point is that means-testing is growing and spreading to become mass means-testing. It is going up and up, and the Minister knows exactly why that is happening. It is because of the endless fiddling by Complexity Brown, the Chancellor of the Exchequer. The question that the Secretary of State must answer is whether he is going to engage with us in this process of reform. He hit the heights of uncharity when, on 9 January, he said that he did not believe that we had anything to contribute to the debate on incapacity benefit and welfare reform. Well, we do, and we are going to scrutinise his proposals.
	In this debate on social security uprating, delivering more support and help to those in need, and giving support to those who want to work but are being prevented from doing so, it would be appropriate to remind ourselves that the Green Paper on incapacity benefit reform—which, we hear, is to become a flagship welfare reform Bill in this Session—comes from a long line of well-meaning attempts from the Government. I counted them up; since 1997, we have had six Secretaries of State and 28 White or Green Papers.
	On close examination, the Green Paper announced in January was found to contain vagaries and obfuscations that give cause for concern, even for a Green Paper. First, existing benefit claimants will not get the help that they need, because the new measures announced in the Green Paper—the proposed work-focused interviews, for example, and the greater frequency of medical assessments—are not obviously going to be applied to—

Madam Deputy Speaker: Order. May I remind the hon. Gentleman that we are not discussing the Green Paper today? We are discussing the social security benefits uprating.

David Ruffley: I am grateful for that guidance, Madam Deputy Speaker, but I took the trouble to look up the last four years' debates on the uprating, and it was my understanding that they roved quite widely. However, I shall observe your strictures. We are talking about benefit recipients, and the benefits that they receive, including incapacity benefit, which is the subject of the order. We are also talking about jobseeker's allowance and the allowances available under the new deal, so, if I may, I shall continue with my remarks, but not specifically in relation to the Green Paper.
	The proposals for change and reform will affect some of the people who are affected by the order today. It is important to remember that the Green Paper is very slack when it comes to detailed costings. The help that people need is not going to be delivered from existing budgets. Benefit recipients—who are the subject of the first order—will perhaps benefit under the extension of the pathways to work programme, which will be funded from existing budgets, but from 2008, there is no indication of the commitment of resources that the Government will need to deliver the help and support that benefit recipients need.
	Another issue related to those who will be affected by the order is the release of the labour market statistics yesterday by the Office for National Statistics. They showed a sharp rise of 17 per cent. in long-term unemployment over the past 12 months. It was particularly noticeable that 18 to 24-year-olds were the hardest hit, with an increase in youth long-term unemployment of more than 28 per cent. in the past year. The figures also show that the number of economically inactive 18 to 24-year-olds is now more than one fifth higher than it was in May 1997. The Chancellor has claimed that he would not be satisfied until he had
	"removed the scar of long-term unemployment from the face of Britain."
	However, yesterday's figures clearly show that he is nowhere near to achieving his goal. His welfare policies—the present ones and the proposed ones—have a long way to go before they deliver for young people. The Government must re-evaluate their approach to long-term unemployment and the economically inactive.
	I must now anticipate the question that I know Labour Members will ask me. It concerns our stance on the new deal. The future loyal Opposition—the Labour party—are keen on saying that we want to scrap the new deal and all its works. Let me place on record, so that it is absolutely clear and there is no misunderstanding, that the new, compassionate Conservative party, under the brilliant leadership of my right hon. Friend the Member for Witney (Mr. Cameron), says unambiguously that the Conservatives, now and when in government, believe in active intervention to get people who can work and who want to work back into work. The principle of the new deal, and of a Government backing welfare-to-work policies, is not in doubt, and I hope that Labour Members will be mature enough to accept that we are all on the same page in wanting to help people back into work—[Interruption.] Hon. Members ask whether I would keep the new deal. The straightforward answer is that every single commitment made in a manifesto is for the lifetime of a Parliament. If the party that put forward those proposals in the manifesto was not fortunate enough to get into government, the basic laws of politics mean that that manifesto would fall.
	My right hon. Friend the Member for Witney has already said that we will be doing patient, long-term policy work on a range of policies over the next 18 months, but let me say that we have grave concerns about how the Labour new deal is configured. Let me tell the House why. We have yet to see any proper evaluation to describe and detail the cost to the taxpayer and to Government budgets for every new job created. Research published by John Van Reenen of the Centre for Economic Performance in April 2004 said:
	"The jobs created are much smaller than the total numbers of young people who have gone through the New Deal and into jobs . . . This is mainly because the majority of those people would have attained employment even in the absence of the New Deal."
	It is difficult to judge from the evidence available how many people have got jobs because of the new deal and how many would have got jobs in any event. In short, the statistics released by the Department for Work and Pensions in, for instance, "New Deal for Lone Parents: Statistics to end of August 2005" show that 42 per cent. went into employment, either sustained or not sustained; 13 per cent. went into employment and in-work benefit; and 37 per cent. went on to income support.
	It seems to us that those figures could be improved. Whether we improve them by revamping or recasting the new deal, we promise the House this: we will do better—

Madam Deputy Speaker: Order. I again remind the hon. Gentleman that perhaps a passing reference to the new deal I could accept, but we are not here to debate the new deal per se. Perhaps he will relate his remarks to the orders on the Order Paper.

David Ruffley: I am grateful to you, Madam Deputy Speaker. I am sure that those who are to receive the uprating and social security benefits will want to know not only what Her Majesty's Opposition think about the quantum of the benefits they will receive as a result of the order going through the House, but what our plans might be for the delivery of those benefits.

Graham Stuart: Will my hon. Friend give way?

David Ruffley: I am happy to give way, but I hope that my hon. Friend does not fall foul of Madam Deputy Speaker's strictures in this respect.

Graham Stuart: Unlike my hon. Friend, I have no intention of doing so, if indeed he did so intend. Like him, I am concerned about any failures of the new deal to get people back into employment in relation to how it then impacts on the number of people who end up back on benefit. Is he aware that in my constituency just 30 per cent. of the people who go on to the new deal for lone parents get sustained, unsubsidised employment and that the number of young people who are on a repeated cycle of going through the new deal and ending up back on benefits is scandalous? To be lectured in the way that we have by the Minister today—as if right is solely on the Government side of the House and that we have no concern for people in that predicament—is appalling and flies in the face of the facts.

David Ruffley: My hon. Friend makes a powerful point in his own way.

Stephen Timms: I can tell the hon. Gentleman that I will receive the announcement that I think he has been making about a significant change of thinking on Conservative policy in a much more friendly way than the hon. Member for Beverley and Holderness (Mr. Stuart). I welcome the change of heart that is being indicated.
	Can the hon. Member for Bury St. Edmunds (Mr. Ruffley) confirm that he thinks that focusing help on young people, lone parents and older people in the way that the new deal has is the right approach to helping people back into work?

David Ruffley: I am afraid that the Minister really needs to pay closer attention to what we are saying. It is not a change of policy to make it clear that manifesto commitments from last year do not subsist for the four years after the general election. He should grow up, or maybe do A-level constitutional history, and understand that we are going through a policy process. Nothing I said suggested that we are endorsing the new deal. In fact, I went out of my way to describe how it is defective, how it needs to be improved and how it does not represent value for money for the taxpayer as currently configured.
	There is clearly a huge chasm between what the Labour Government are saying on the results of the new deal and what can be delivered by greater and more effective use of the third sector and private sector delivery. The fact is that the Government have failed utterly with the new deal as configured to get enough people into work—sustainable work—as quickly as they would like to get into work. However, I shall return to the burden of my argument. I had to put to rest a canard that the Minister was trying unjustly to lay on us. There has been no policy change in that respect.
	On pensions and the income that our pensioners enjoy, will the Minister tell us what consideration he is giving to uprating the basic state pension in line with earnings? I would be interested to hear how much more the basic pension would be next year if it were increased in line with earnings rather than prices this year? I ask that because my hon. Friend the Member for Eastbourne (Mr. Waterson) asked the same question of the Minister last December. I would be grateful if he provided us with an answer.
	Lord Turner's proposals contain an important central conclusion, which is that means-testing for pensioners should be reduced. Nearly half of all pensioners depend on means-tested benefits, which is an increase over the past eight years. By 2050, that proportion will have risen to more than 70 per cent.

Graham Stuart: Disgraceful.

David Ruffley: As my hon. Friend says from a sedentary position, it is indeed disgraceful. I repeat that by 2050 the proportion will have risen to more than 70 per cent. if Government policy is continued. Pension credit is not being claimed by 1.7 million pensioners who are entitled to it, and the latest figures show that despite all the money that is being spent on advertising and the no doubt sterling efforts of the Pension Service, take-up does not seem to be shifting.
	Another question for the Minister, which relates directly to the orders, involves the confusion introduced by the Chancellor to the debate in relation to the pension credit link to earnings, or is it prices? We know that the pension credit is linked to earnings in uprating terms until 2008, but in a rather transparent attempt to torpedo Lord Turner's proposals, even before they saw the light of day, the Chancellor told Lord Turner
	"you should not assume that the current"
	link of the pension credit to earnings
	"will continue beyond 2008".
	It would be helpful if the pensions Minister told us what his assumptions are. Before he says, "Well, that's for a future Budget and the Chancellor," I would have thought it incumbent on him as pensions Minister to tell us his Department's long-term thinking.
	The Minister is rightly engaging in the rhetoric of long-termism and of patient solutions. Lots of hard work needs to be done to plan for the long term. On pensions, who could disagree with that? But, it would be useful to know about the short term, not so much the long term, as 2008 is not far away. We look forward to an answer to what is a fairly simple question. Many pensioners listening to the debate and those who hear about it subsequently will want an answer.

Anne Begg: Perhaps this is an occasion on which if the hon. Gentleman shows us his, we will show him ours. As he is asking what the Government's proposals are beyond 2008, can he tell us what Conservative policy will be in 2008, because he has ruled that out with regard to the new deal up to now?

David Ruffley: I am sure that the hon. Lady will accept two things. First, my right hon. Friend the Member for Witney has made it clear that we will engage in patient long-term policy work, and our position will certainly be clear after 18 months. Secondly, it is not a question of not knowing; what we do know is that we do not indulge in the knee-jerk reactions and grab-a-headline policy making on the hoof, which, I am afraid, is the distinguishing hallmark of Labour Ministers over eight years and the Liberal Democrats. What is refreshing about the new Leader of the Opposition is that he has stamped his mark on a host of issues by saying, "Listen, we're going to think outside the box and think afresh. We're going to deliver solutions not just for the next week or the next 12 months, but for a whole Parliament." If Ministers can be a bit patient and listen to what we will say, openly, in our policy commissions, they might learn something. They have had eight years in which to come up with a long-term solution and to think the unthinkable, and all that they have come up with is sacking the people who think the unthinkable and—

Madam Deputy Speaker: Order. The hon. Gentleman has been given some leeway. Perhaps he will now confine his remarks to the order before the House, and not be led astray.

David Ruffley: I will not be led astray, Madam Deputy Speaker. I just try my best to be courteous to Members who intervene on me, and to give straight answers to straight questions, which I thought that I had done. If that requires me to be led astray, I shall not do it in future, or certainly not in this debate.
	In relation to the Turner report, the Minister said in his December speech:
	"We will bring back proposals in the spring, which I hope will be on the basis of as broad a consensus as possible".—[Official Report, 6 December 2005; Vol. 440, c. 746–7.]
	Will the Minister tell us whether that timetable is still operative, and when in spring we might expect the Government's response to Turner? I do not wish to try your patience, Madam Deputy Speaker, by referring again to the incapacity Green Paper, but that was an important document postponed from last summer that did not see the light of day until January, after at least two or perhaps more postponements—

Philip Hammond: And two changes of Secretary of State.

David Ruffley: And, as my hon. Friend reminds me from a sedentary position, after two changes of Secretary of State.
	We also know that take-up of the benefits, which are the subject of the order, is low and needs to be higher. The latest statistics show that in 2002–03 alone, pensioners were failing to claim up to £2.9 billion in means-tested benefits. That low take-up might explain in part why 2 million pensioners are still living in poverty. That is not acceptable, and all politicians of good will find it so and want to come up with solutions to solve the problem.
	The Minister told us in December that in relation to council tax benefit take-up, the Pension Service is ringing up pensioners in receipt of pension credit to encourage and help them to apply for council tax benefit and housing benefit, if they are entitled to them, in order to increase take-up. It would be useful if the Minister were to give us more detail than was available in December to explain what targets he has in relation to that statement, and what progress he expects.
	As a direct result of the huge failure of many occupational schemes over the past seven years, many pensioners find that they do not have the resources and income for which they were hoping, and find themselves in poverty and relying on the benefits that are the subject of both orders. We know that the Chancellor, in his first emergency Budget of July 1997, raided pension funds to the then value of £5 billion a year. Under the Chancellor's watch, we have had a poorly performing stock market in this country relative to other mature, western industrialised economies, longevity has increased, which the actuarial profession—oddly, in my view—did not predict as well as it might have done, and more pension funds are closing. We were reminded, in a reply to my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond), that more than 60,000 occupational pension schemes with a total membership of more than 1 million people have been wound up or have begun the process of winding-up since Labour took office in 1997.
	Alongside an £800 billion black hole in public sector pension funds, and a £93 billion deficit in the pension funds of major businesses, those figures show that more and more pensioners face an uncertain future, and a future on benefit. Will the Minister give us his views on that, and share with us, as much as he is able to do, the Department's thoughts on the Turner proposals?
	Let me remind the House of what the right hon. Member for Birkenhead (Mr. Field) said last year in relation to the issue of pensioners and their incomes:
	"The big issue that ought to be worrying the whole of the Government, because it's worrying voters, is that when Labour came to power we had one of the strongest pension provisions in Europe and now probably we have some of the weakest."
	That bears directly on benefit take-up and on the amount of money that many of the people who will be affected by the orders will take home, either in terms of in-work benefit or help when they are pensioners.
	When this debate takes place at the same time next year, I hope that fewer people will be in dependency, and that fewer people will need support, either because they have got back into work or have been able to make arrangements in relation to their pensionable age so that they do not have low incomes and do not have to rely on benefit when they do not wish to do so. However, given the confused approach that the Government have demonstrated in relation to Turner, with the Treasury saying one thing and the Department for Work and Pensions saying another, and the gaping holes in the welfare reform proposals of the January Green paper, the major part of which will not take effect until 2008 in any event, my concern is that we might not see any change in the next 12 months, and that when we debate the issue again, too many of our fellow citizens will too often have to rely on benefits.

Danny Alexander: I welcome the chance to debate the orders before the House, which, like Conservative Members, Liberal Democrat Members will not seek to oppose.
	In debates on this order in recent years, Members have complained about and discussed in some detail a perceived lack of overall strategy from the Government on issues relating to benefits and pensions. This year, with the welfare reform Green Paper and the second report of the Pensions Commission, it is fair to say that debate on the future strategy for pensions and benefits finally seems to be taking off. How far it will get off the ground, however, remains to be seen in the coming months.
	As a result of the orders, the UK basic state pension will be increased from £82.05 to £84.25. That is still well below the poverty line, and well below the level of means-tested benefits, such as pension credit, which, as a result of the orders—assuming that they are passed, and it sounds as though they will be—will be £114.05 for next year.
	The Government's own figures, to which the Minister referred, show that 20 per cent. of pensioners in the United Kingdom still live in relative poverty. About 1.7 million are not claiming the pension credit—mentioned by the Minister, among others—to which they are entitled. Moreover, figures released last month by the Office for National Statistics suggest that about 2 million more pensioners are not claiming the council tax benefit to which they are entitled. I should like to know what further efforts the Government will make to promote take-up of those two benefits.
	While the minimum income guarantee will increase by 4.2 per cent. in line with earnings, pensions will increase by only 2.7 per cent. in line with prices. Given the lack of take-up of some benefits, including pension credit, that approach means a continuing increase in the relative poverty experienced by the poorest pensioners. It should also be borne in mind that if the Government maintain their current policy, means-testing will extend to about 70 per cent.—some say 80 per cent.—of pensioners by 2050.
	Owing to the structure of the pension credit system and the extension of mass means-testing, which was mentioned earlier, there will always be a group who fail to take up means-tested benefits. The system is imperfect, and that is one of its chief flaws. The more people depend on means-testing, the larger will be the group who are left in poverty through non-claiming. The growth in means-testing, which is not altered but perpetuated by the orders, also makes the benefits system more complex and gives people a powerful disincentive to save for themselves.
	Last year, more than 50 per cent. of people of working age made no pension savings for themselves, relying almost entirely on their partners or the state to support them in their retirement. That is why the Liberal Democrats welcome many of the recommendations in the second report of the Pensions Commission under the chairmanship of Lord Turner. We agree with the report's basic analysis and its long-term vision of the pensions system. We want to work with all parties to build a consensus based on Lord Turner's proposals.
	One of the jobs that I did before my election was working for the Britain in Europe campaign, which promoted British membership of the European single currency. There are certain worrying parallels between the Government's approach to pensions and their approach to Europe. The Minister recently announced five tests that he wishes to apply to pensions—there were five tests relating to the euro. The Minister told us earlier that the Government were promoting a great national debate on pensions—such a great national debate on the euro was promoted by the Prime Minister and, indeed, the Chancellor. Ultimately, the euro fell through the chasm between No. 10 and No. 11 and was kicked into the long grass, to remain there for many years to come—probably much to the appreciation of some Conservative Members.

Jeremy Hunt: Does the hon. Gentleman agree that the outcome of the euro debate was the Government's adoption of a Conservative position? Might the pensions debate have the same outcome?

Danny Alexander: I see that we are trying your patience again, Madam Deputy Speaker, so I shall not respond to that intervention in too much detail. What worries me about the current approach is that, as in the case of earlier policies to which I have referred, the issue may not be resolved for many years because of political difficulties within the Government.
	The Pensions Commission's report recommends the introduction of a more generous flat-rate universal state pension, to be paid to those who qualify on grounds of residency in the United Kingdom rather than on the basis of national insurance contributions. I wholeheartedly support that recommendation. Indeed, the Liberal Democrats have made a similar commitment to a citizens pension. We have costed proposals for its introduction in the context of a raised retirement age.
	It is sometimes said—and such a conclusion might be drawn from the orders—that the state can no longer afford to pay a decent and universal pension, and people must therefore provide for themselves. While I believe that people must indeed provide for themselves, I also believe that they should benefit from a much larger basic state pension. After all, ours is the fourth wealthiest economy in the world. I believe that if we can forge a national consensus, people will support the measures that will be necessary to pay for a more sensible, coherent foundation for pensions provision.
	We support Turner's proposal for a universal state pension at a level that will lift all pensioners out of poverty. I hope that Members throughout the House will join us in rejecting the mass means-testing of pensioners that the orders encourage and would perpetuate, to ensure that every pensioner is given his or her full entitlement.

Daniel Kawczynski: Will the hon. Gentleman give way?

Danny Alexander: I will give way to the hon. Gentleman, with whom I expected to be in the Falkland Islands today.

Daniel Kawczynski: I thank the hon. Gentleman. He is right: we were meant to be together in the Falkland Islands today.
	Many young people in Shrewsbury tell me that they are not taking out pensions because of the huge tax increases levied on them by the Government. Does the hon. Gentleman agree that it is worrying that the younger generation are not arranging private pensions, as he said they should, because they simply cannot afford to?

Danny Alexander: I believe that one of the main reasons why many young people are not making their own pension provision is the spread of means-testing, which in a sense devalues that additional saving.

Jeremy Hunt: Does the hon. Gentleman agree that although money is an important element of the eradication of poverty—an aim that is shared throughout the House—we must also consider the need for a simpler system that does not remove incentives to work? Does he also agree that while the Government may have increased funding for poverty eradication programmes, they have not succeeded in introducing policies that would make the system simple enough to understand, while retaining incentives for people to return to work if they are able to do so?

Danny Alexander: I intend to say something later about the disincentives to work that will continue if the orders are passed.
	People outside may look forward to receiving uprated benefits or pensions. How those benefits are delivered, and whether people will be able to take advantage of them, is an issue of fundamental importance. The Minister will know that some 4.3 million people receive the benefits in pensions that we are discussing via a Post Office card account. He will know, because we discussed it in Westminster Hall yesterday—

Madam Deputy Speaker: Order. I hope that the hon. Gentleman is not going to enter into a debate on the Post Office card account, given that the order concerns the uprating of social security benefits.

Danny Alexander: I do not intend to enter into a great debate on the Post Office card account, and I am grateful for your guidance, Madam Deputy Speaker.

Alan Reid: If pensioners living in remote areas find that because of Government policy their pensions increase only in line with average prices, and if because of Government policy their local post offices have to close and they face a longer journey to collect their pensions, they will face greater financial burdens as a result of Government policy. That is not reflected in the pension increase that the Government are giving them. If the Government adopt a policy of wholesale post office closures, surely they should give pensioners in remote rural areas larger increases because of the greater distances that they must travel.

Danny Alexander: My hon. Friend makes an extremely good point. If, as a result of the Government's policy, the means of access to benefits and pensions—local post offices in rural areas or deprived urban areas—is removed, the uprating should include an amount that makes it possible for people to gain access to those benefits and pensions. Otherwise, while there may be a superficial uprating, increased costs will mean an overall downrating for those people. I hope that the Minister will address that issue, and particularly the question of when people living in such areas might lose the ability to access benefits in the manner of their choosing. I hope that the Government will provide time in the near future for a full debate on this issue, because Ministers have so far been unable to address it on the Floor of the House.
	I come to the future of disability benefits, with which the orders before us also deal. We Liberal Democrats will make a formal submission on this subject in response to the Government's Green Paper on welfare reform, but there are a few points that are worth making in the context of today's debate. Although we endorse, for example, the various forms of support being offered to people on incapacity benefit to get them back into work and, therefore, off the benefit currently provided in the pathways to work pilot areas, if such support is to be extended throughout the country to all people in receipt of incapacity benefit it needs to be properly funded. The Government estimate that the pathways to work project costs some £400 per claimant. Based on the latest annual figures for people commencing incapacity benefit claims, it would take some £220 million a year to fund a national roll-out at the same level. Yet the Government are offering only £360 million over two years. If the resources are spread too thinly, we will not see results and we will let down all those claimants who want to find work. That is especially true at a time of rising unemployment.
	Conditionality of benefits has been a major feature of the debate on the future of benefits such as jobseeker's allowance and incapacity benefit. That debate continues.

David Ruffley: This seems something of a groundhog day, in that the hon. Gentleman is repeating the speech that I attempted to make a few minutes ago. Does he share my concern about the funding of proposals aimed at getting incapacity benefit recipients back into work?

Danny Alexander: I am grateful, I think, for that intervention. If the hon. Gentleman had been paying closer attention a couple of minutes ago, he would have heard me make exactly that point. Perhaps he was too busy re-reading his own speech to listen to mine.
	On benefit sanctions and conditionality, I am concerned that the Government have so far been unwilling to make public detailed clear evidence of the success of such sanctions in encouraging people off benefit and back into work. I have asked the Minister on a number of occasions to provide the body of evidence to which he referred in support of the Government's claim, but so far he has been unable to do so. According to the Green Paper, they
	"do not intend to make changes to Disability Living Allowance as part of these reforms".
	That is a great disappointment, because the benefits paid to disabled people that are covered by this order—disability living allowance, incapacity benefit and so on—need to be reviewed in the round if we are to establish an effective overall structure that targets resources to need.
	The Government's own research—the Department for Work and Pensions working paper No. 21—suggests that the disability living allowance as currently structured is not sufficient to meet the extra costs faced by people with disabilities. What are the Government doing about that issue? They have missed an important opportunity to consult on it. Indeed, they dodged giving a straight answer to a written question on it just a few days ago. Will the Minister explain clearly how the Government intend to respond to this finding, rather than following the example of the parliamentary written answer that I received and simply restating the research's conclusions?

Jeremy Hunt: I am grateful to the hon. Gentleman, who is being very generous in giving way. Is he aware of research by the Joseph Rowntree Foundation, which quantifies the cost of being disabled at an additional £200 per week net of any extra benefits received, or £118 per week for someone in employment? Is he concerned, as many disability charities are, that the structure of the Government's proposed incapacity benefit reforms seems to assume that some people are completely incapable of work? For many people with severe learning disabilities, working even one or two days a week could well be the way out of dependency and of regaining some self-respect.

Danny Alexander: I am grateful for that intervention and I am aware of the excellent research to which the hon. Gentleman refers. I will turn shortly to the question of how the uprating of benefits affects those who are able to work only a few hours a week.
	Some important issues need to be considered. For example, the current disability living allowance does not provide support for the communication needs that many disabled people have. Some 4,000 disabled schoolchildren with such needs have been fortunate enough to receive support from the communication aids project, which is funded by the Department for Education and Skills. Unfortunately, such funding ends in March and the Department has no plans to renew it. A review of disability living allowance could—indeed, should—consider whether support for communication needs should be given, in addition to support for care and mobility.
	In his opening remarks, the Minister pointed out that disability living allowance applies whether one is in work or out of work, and it is true that that is one of that benefit's potential strengths. However, in the experience of many organisations that help benefit recipients back into work, a return to work can often quickly trigger a new review of entitlement to disability living allowance. That issue needs to be addressed.
	The uprating of benefits inevitably increases the sums lost to the Exchequer through error and fraud in the benefit system. Although some progress has been made in tackling fraud, it has been insufficient to prevent the Department being criticised strongly by the National Audit Office and the Public Accounts Committee. The latter says that the Department has
	"a long way to go"
	in this regard. On errors, the picture is even more unclear. In fact, it seems likely that the number of benefit payment errors is increasing. They now account for more losses than does fraud: some £1.5 billion, according to the PAC's estimate. In a recent debate, the Government pointed out that the figure is actually £1.7 billion. Perhaps the Minister will give the House the Government's latest estimate of the amount that will be lost through errors in the benefit system as a result of the upratings before us today.

Philip Dunne: Does the hon. Gentleman agree that it is extraordinary that for the 16th or 17th year in succession, the Department's accounts have been qualified and not signed off? Is it not surprising that sorting out their own Department's accounts is not Ministers' highest priority?

Danny Alexander: I am grateful for that intervention and I agree that that should be a priority. The DWP has a number of issues that it needs to sort out, many of which are high priorities: the Child Support Agency is one, as is the Post Office card account. None the less, the issue that the hon. Gentleman highlights should be given much greater attention.
	I come to housing benefit and the existing incentives to work. Chapter 6 of the welfare reform Green Paper is entitled, "A radical new approach to Housing Benefits". There must have been a mistake in the copy that I received, because all that it had was a not very radical chapter on how the not particularly radical local housing allowance might be rolled out nationally. Perhaps the explanation for that is simply the gap between rhetoric and reality to which we have become all too accustomed from this Government over the years.
	The uprating before us today once again fails to uprate earnings disregards for housing benefit and council tax benefit. In 1988, £5 of a single person's earned income was disregarded. Today, the figure is still £5, but it is a devalued £5.

Graham Stuart: Bring back Mrs. Thatcher!

Danny Alexander: I believe that Baroness Thatcher is entitled to other benefits these days. If uprating had at least kept pace with inflation, the earnings disregard for housing benefit and council tax benefit would now be £8.35. In other words, the Government are clawing back from the poorest people £175.20 per year per person by not uprating these disregards. I urge the Minister to pay close attention to that issue in future years.
	An even greater disincentive to work is the combined housing benefit and council tax benefit taper, which withdraws 85 per cent. of people's earnings for every extra pound earned. All Members will doubtless have heard constituents complain about this issue, and I am pleased that the Minister confirmed in a written answer to me that the pathfinder project evaluation would examine income tapers. I hope that the Minister will give a further assurance that it will form a substantial part of the evaluation, and the recommendations that are to follow.
	Finally, I turn to another group of people directly affected by the orders—claimants who are single or under 25 years of age. Young single claimants are often overlooked, but they face growing inequality as the gap between their incomes and the average income widens because their benefits are linked to prices. There is a prejudice against people aged under 25, who are especially hard hit by lower benefit rates and the unfair single room rent.
	In opposition, the Government opposed the single room rent. Many Labour Back Benchers have supported parliamentary motions calling for it to be ended, and Shelter reminds us repeatedly that it causes homelessness.The median rent shortfall for those receiving the single room rent is £31 a week. These orders will raise to £45.50 the jobseekers allowance paid to people under 25, but subtracting from that amount the £31 rent shortfall caused by the housing benefit regulations means that they will have only £14.50 to live on each week.The system is unfair. It increases homelessness, encourages fraud and can also help to promote the grey economy. Government estimates are that 12,000 young people were subject to the single room rent in May 2005. At an average shortfall of £31, it would cost only £372,000 to end the single room rent. Can the Minister find that amount in the Department's budget?
	As I said, my party will not divide the House over these orders. We are happy to support the benefit uprating proposals, but the Government still face substantial challenges in respect of pensions and welfare policy. They are far from meeting those challenges at present, and I look forward to their response to the debate.

Graham Stuart: It is a privilege to follow the speeches by my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) and the hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander), who put the proposed upratings into context. The Government came to power in 1997 promising radical and ambitious reform, and the Prime Minister vowed that the cost of what he called failure would be reduced in the first five years of the Labour Government. In the event, the cost of failure has risen since the Government came to office.
	The backdrop to any uprating of benefit is the general state of the economy. In 1997, the incoming Labour Government had an opportunity to reform the welfare state that was without parallel since its formation. We all support the welfare state if it gives people dignity rather than means-testing, and relieves poverty rather than continues it. The unparalleled opportunity to reform the welfare state was the result of the transformation of the economy that took place under the previous Conservative Government.
	In 1979, the British economy was a basket case, but by 1997 it had become the strongest and most powerful in Europe. The Labour Government inherited that economy, but unfortunately they have squandered the legacy, to the detriment of some of the poorest and most vulnerable people in this country.
	As the articulate spokesmen for both the main Opposition parties have made clear, the result has been that the people with least have been let down. The British economy had returned to being the powerhouse of Europe in 1997, but the opportunity to reduce the number of people languishing on incapacity benefit has been lost since then. The number of people claiming that benefit was 2.37 million in May 1997, but by February 2005, it had risen to 2.68 million. That is a testament to the Government's failure to deliver for those with least, and the backdrop of economic strength bequeathed by the previous Conservative Government makes it all the more shameful. I hoped that the Minister would show more humility and display more of the quality of grace that he mentioned when he opened the debate.
	The question of benefits uprating touches certain key elements of the approach of Government and all political parties to dealing with the most vulnerable people in our society. Ministers repeat their mantras about providing for the many, not the few. They apply words like "radical" and "ambitious" to their plans for looking after those with least. That may be electorally effective, but my right hon. Friend the Member for Witney (Mr. Cameron) is equal to the challenge of making it clear to people that the Conservative party has always been dedicated to the improvement of those with least in our society. For example, William Wilberforce led the movement to abolish slavery, and the 19th century's 10-hour working day initiative was led by a Conservative.
	Over the past 100 years, the Conservative party has been entrusted with uprating benefits on more occasions than the Labour party. That is because the people of this country recognise that we are committed to social justice and to uplifting the poor. Disraeli and any number of other Conservative leaders have supported the notion of Britain as one nation, with a benefits system—the uprating of some elements of which we are discussing today—implemented to best effect.

Danny Alexander: The hon. Gentleman is in full flow about something for which he feels great passion. I do not want to interrupt him so much as inject a little balance. He has mentioned incapacity benefit. During the years of Conservative Government, the number of people receiving incapacity benefit ballooned. That might have been because that Government wanted to massage down the unemployment figures and massage up the figures for incapacity benefit.

Madam Deputy Speaker: Order. Before the hon. Gentleman replies, perhaps I might remind hon. Members again that we are debating the current proposals for uprating social security benefits.

Graham Stuart: Thank you for your strictures, Madam Deputy Speaker. I am aware of them and will observe them meticulously.

David Ruffley: We are all aware of them.

Graham Stuart: My hon. Friend is right, but I hope that I might be allowed a final sally in respect of incapacity benefit. Although the number of claimants ballooned under—

Danny Alexander: Many are still claiming incapacity benefit today.

Graham Stuart: That is true, but it is why it is all the more shameful and sad that the Government have squandered the unparalleled opportunity presented by the transformed economy that they inherited and have let down the people who most need help.
	The Minister used the interesting word "consensus". I have been in the House only since last May, and I try not to be cynical, but whenever I hear a Minister use that word I know that he is presiding over a system that is chaotic and failing. That is why, in a desperate bid to shore up his weakening political position, he uses that word to seek the support of the Opposition.
	However, the good news from my hon. Friend the Member for Bury St. Edmunds is that the Conservative party is always prepared to work for the good of the most vulnerable people. We will work to achieve consensus to support them and give them the dignity of work. People want dignity, not means-testing.
	I am nervous of touching on the new deal but shall do so only in passing and certainly less than the Minister did. Only 15 per cent. of people aged more than 25 who were out of work when the so-called successful new deal was introduced—that is, only one person in seven—have returned to work and so no longer need to claim benefits. Six out of every seven benefit claimants have been failed by that enormously expensive and bureaucratic programme.
	I welcome the Conservative party's continuing commitment to programmes that will help and support people and get them into work. In contrast to what too often amounts to political posturing among Labour Members, I do not even mind if we keep the new deal name. That is a matter of indifference to me, as long as we move away from the politics of failure and get all those people still languishing out of work back into employment. That is what the Conservative party is about. That is why we transformed the economy, and that is the opportunity that I hope that we will take on again when we next form the Government.
	The Minister referred to the number of children in poverty. He will be aware, although he is no longer in his place, that the percentage of children experiencing persistent low income—those in the unhappy state of remaining below 60 per cent. of median household income in at least three out of four years—was 16 per cent. in 1996–97 and remained at 16 per cent. for the following three years to 1999–2000. We need to recognise that far too many children still live in poverty and that the Government have not delivered the transformation that they promised. I hope that we will see fewer eye-catching initiatives and more hard work to make the systems that we already have work better. When we have a Conservative Government, we will make the systems work better. We will be less interested in headlines and more interested in reducing poverty for those with least.
	The Minister's words on pensions were hardest to take. As my hon. Friend the Member for Bury St. Edmunds said, Labour's first Minister with responsibility for welfare reform said last year that when Labour came to power we had one of the strongest pension systems in Europe. Now we have one of the weakest. That is a searing indictment of the Government's failure. They have removed opportunity from hard-working people and replaced it with means-testing. I have yet to meet a constituent, whether from the far left like so many Labour Members who rebel against the Government, or from the right, or of no known political persuasion, who wishes to spend their life working hard and paying tax in order to end up on means-tested benefit. They do not want to have to fill in 24-page forms to get pension credit or 12-page forms to get their council tax benefit.
	When I attended the Hornsea pensioners annual Christmas lunch, I sat beside an upstanding, hard-working, socially contributing and economically successful member of the community who, in his old age, has, because of the Government's £5 billion raid on pensions, ended up in need of means-tested benefits in order to live properly—[Interruption.] Ministers may laugh at the predicament of hard-working, decent people who are forced into relying on means-tested benefits at the end of a life in which they have suffered no ill-luck and no great illness. They consider themselves successful members of our society. They have always worked, they brought up their children and they tried to do the right thing. This Government have made such people feel like beggars from the state. The gentleman whom I sat next to at Christmas lunch told me that he had seen adverts saying, "It's yours: claim it". So, he filled out all the forms and sent them off. By return, he was told that his building society accounts had not been sent in original form and was asked to supply every last one, even one that had £80 in it. He told me that he chucked the lot in the bin. The 1.5 million people in the same situation deserve better, but they have been let down by a Government who are addicted to means-testing instead of providing dignity for people in their old age.
	Age Concern estimates that more than 2 million retired people are living in households with incomes below the Government's official poverty line. I would have thought that Labour Members would be campaigning vociferously on behalf of women, who benefit least from the current system. We know that fewer of the recently retired have money coming in from an occupational pension. We also know that 1 million people have seen their occupational pension schemes wound up—more than 60,000 schemes—because of the policies of this Government, who have raided pensions to the tune of £5 billion a year. That is not a modern, active and inclusive welfare state. For Ministers to persist in saying that is nothing short of a deception of the British people, and I hope that it will be increasingly recognised as such.
	Pensioners, people on incapacity benefit and people on the new deal—in other words, some of the most vulnerable people in our society—are not well served by the benefits uprating today. They are being let down. The basic state pension, for people who have contributed all their lives, was 21 per cent. of average earnings when this Government came to power, but it is now just 15.9 per cent. That is the legacy that this Government will leave.

Peter Bone: My hon. Friend is making a powerful speech and has reached the crux of the issue. If the Government would only uprate pensions in line with earnings, not the retail prices index, it would help many pensioners and, over the years, remove pensioner poverty.

Graham Stuart: That is my next point. At the election, the Conservative party laid out proposals to help to lift pensioners out of poverty, to bring them dignity and not means-testing, and to bring back the link between average earnings and the state pension. Labour Members will point out that that link was removed by the Conservatives, but I ask them when that happened. It was in 1980, at the end of a decade in which Labour Governments had brought the economy of this country to its knees. That is why we had to remove the link. By 1997, we had transformed the economy, which is why Labour Members should join Help the Aged, Age Concern and the National Pensioners Convention—indeed, everyone associated with pensions except the Chancellor of the Exchequer—in believing that we should bring back the link between average earnings and the state pension. We should not allow the number of people dragged into the hole between pension credit and the state pension to increase. It is beyond belief that we can even consider having 70 per cent. of people dependent on this Government's mean means-tested benefits in as short a time as 44 years.
	We need a Conservative Government to lift people out of poverty, because they want dignity, not means-testing. We need to bring back the link, and we need to stop the Chancellor of the Exchequer's pernicious, poverty-inducing increases in council tax. We had proposals to deal with those issues at the last election, and I look forward, under the leadership of my right hon. Friend the Member for Witney, to my party coming forward with a considered position that will help to bring dignity back to the people of this country and provide hope for those with least.

Philip Dunne: I am conscious of your strictures, Madam Deputy Speaker, to confine our remarks to the topic for debate, and I shall endeavour to do so. I hope that you will allow the odd lapse.
	Yesterday, I received a helpful press release from the Office for National Statistics, which suggested that we are at a tipping point for the potential number of claimants. For the first time for some years, the trend in employment is declining and the number of people unemployed is increasing. That is noticeable and I shall remind the House of the statistics. The unemployment rate has increased from 4.7 per cent. to 5.1 per cent. over the period October to December 2005. The number of unemployed people has increased by 108,000 over that quarter and by 123,000 over the year, to reach 1.54 million. In tandem with that alarming increase, there has been a significant increase in the inactivity rate for people of working age. That is relevant to the debate because it affects potential claimants.
	The number of economically inactive people of working age has risen by 59,000 to reach 7.95 million—the highest figure since comparable records began in 1971. At the same time, the average number of job vacancies for the three months to January 2006 was 616,800, which is down more than 34,000 over the previous 12 months. While unemployment is rising, job vacancies are declining, which suggests that there may be a significant change in the number of claimants in the coming year. It will be interesting to see what—if anything—the Chancellor makes of that in his Budget statement next month.
	A connected issue relating to those in receipt of benefits is tax credit. We have been told that, from April 2006, the level of income that the Chancellor will disregard, which was £2,500 a year, will rise significantly to £25,000—a move that I welcome as it will take a large number of tax credit recipients out of the pernicious series of negotiations with the Inland Revenue into which they are required to enter to determine whether they are entitled to tax credit as their income changes during the year. All Members will have countless examples from their advice surgeries of members of the public who cannot understand the informative—I shall be polite—letters that they receive from the Revenue on that subject.
	I wanted to know the cost of that move to the Exchequer, so I put a parliamentary question to the Chancellor last month. I received a reply from the Paymaster General, who was incapable of providing the information. I shall read part of the reply, which stated:
	"The increase in the disregard from £2,500 to £25,000 from April 2006 is part of a package of measures announced in the 2005 pre-Budget report . . . It is not possible to produce robust estimates of the impact of individual elements of the package of measures, as there are significant interactions between the different components."—[Official Report, 26 January 2006; Vol. 441, c. 2246W.]
	That answer is not acceptable. It is beyond belief that the Chancellor could announce such a major measure, which will have an impact on a large number of people, without understanding its effect on the public finances. I shall be looking for clarification in the Chancellor's Budget statement.
	Another aspect of tax credits relates to the issues we are discussing: the impact of child support measures. It was disappointing that, in his pre-Budget report, the Chancellor failed for at least the second successive year to uprate to any degree the family element of child tax credit, which has been frozen—as indeed has the child care element of working tax credit. Both measures would have done something to help families on the lowest incomes out of child poverty.
	I turn to the pension element of the uprating. I have been following with some interest the statements about pensions of the Minister for Pensions Reform, who is not in his place, so I welcomed his comment in this debate, when he appeared for the first time to acknowledge the need to encourage incentives to save. Under the Labour Government, savings have roughly halved nationally. One of the main contributory reasons is the introduction of so much means-testing in the pensions environment. It is essential that the Government's measures in response to the Turner commission reduce dependency on the state and on means-testing, and they have acknowledged that as an important ambition. I shall look particularly at how they achieve it and should welcome the opportunity to participate in that debate over coming weeks.
	I urge the Government to take care that they do not damage the existing savings regime in our pensions industry. It has already suffered significant damage from measures taken by the Government, as we heard earlier, so it would be the height of folly if the introduction of a low-cost national pension savings scheme, or its equivalent, caused the migration of all existing savings arrangements to that scheme to the detriment of pensioners and the savings industry.
	It is also important that the Government do not fall into a mis-selling trap of their own making. It could be avoided if there were an element of compulsion in the national pension savings scheme. If there is an auto-enrolment system, as proposed by Lord Turner, individuals must be given some advice, one way or another, to determine whether saving for their pension is right at a particular stage of their working life. I am thinking particularly of graduates at the beginning of their careers who have to pay off tuition fees and so on. Is it really appropriate for them to be saving for their pensions at the beginning of their career when they have costly debts to pay off?
	I also urge the Minister to ensure that there is sufficient confidence in whatever savings scheme is established to allow people on lower incomes to participate if they want to do so. Experience has shown the difficulties of previous Government schemes that were rolled out with great fanfare but not taken up in the numbers that the Government wanted, in part because people felt that the Government would not play fair with them and the rules were changed. I do not criticise this Government particularly because all Governments have a tendency to change the rules as they go along, so whatever regulatory oversight regime is in place, there should be an element of independence. Just as, to their credit, the Government introduced independence for the Bank of England, they should consider a regulatory oversight regime for the national pension savings scheme that is independent of Government.

Danny Alexander: Does the hon. Gentleman agree that one of the most significant disincentives for people on low incomes to make provision for their retirement is the spread of means-testing in the pension system? People on low incomes are likely to be much more affected by means-testing, so the current system is much less likely to encourage them to make provision for their retirement.

Philip Dunne: I completely agree. Indeed, until two years ago when the Government made the change, it made no financial sense for many people on low incomes to save because they were better off depending on the state in their retirement. The Government have taken some steps to reduce that disincentive to save but it still exists to some extent.
	Incapacity benefit is also being uprated. I do not want to comment at length on the welfare reform Green Paper, as I am aware of Madam Deputy Speaker's strictures on the subject. However, it discusses the need for a reduction in the number of IB claimants over the next 10 years, and how we achieve that is relevant to the debate. All Members can agree that the aim is desirable, but it is a major challenge for the Government and there are some specific problems that they need to address.
	The vast majority of the 2.7 million IB claimants have been in receipt of the benefit for more than four years. We are dealing with a large proportion of people who are in the most difficult category in terms of getting back to work. They include some of the most vulnerable people—the most severely disabled and the most persistently unemployed. Whatever the Government may say about the previous Conservative Administration's attempt to shift people from unemployment benefit to incapacity benefit, the number of IB claimants under the Labour Administration has risen significantly—it has gone up by more than 300,000—so they cannot make that accusation without acknowledging that the number has risen significantly under Labour as well.
	The pilot pathways-to-work schemes that the Government have introduced over the past couple of years are making modest progress in increasing take-up, thus getting more people back into work. The percentage for each pilot area varies between about 7 per cent. and about 11 per cent. I acknowledge that that is an improvement, but that is the percentage increase for all claimants in the area, irrespective of the duration of their being on incapacity benefit.
	Our performance, even in the pathways areas, is not as good as that in other countries. As a member of the Select Committee on Work and Pensions, I had the advantage of visiting Holland with other Members last week, and some dramatic and significant reforms have taken place there over the past few years, as I am sure the Minister is aware. Particularly in addressing long-term incapacity benefit claimants, great strides are being taken in changing the attitudes of people in receipt of benefit and putting in place an array of measures to encourage people back into work.
	The main focus in Holland is on making employers and individuals who have disability aware of the fact that they have the potential to work. The focus is on what they can do, not what they cannot do. Although that is a rather simplistic description, that change in attitude is dramatic. Unfortunately, the pathways pilot schemes do not provide that. They continue to encourage people to think that they have a right and an entitlement to benefit and to think about what they cannot do and what they are entitled to if they cannot do it. The Government need to address that change in attitude.
	The Minister is aware of the final issue that I should like to raise, which relates to how the Department for Work and Pensions copes with the voluntary and private sector agencies with which it enters contracts to supply training and other services to long-term incapacity benefit claimants. The Department is in the midst of reviewing its relationships—and it needs to do so, because they have been chaotic. We have evidence from many of those organisations to show that the Department has been running its supplier contracts in such a way as to shut them all down—

Madam Deputy Speaker: Order. I have given the hon. Gentleman some leeway, but he is going rather wide of the mark. I repeat once again that we are debating the uprating orders.

Philip Dunne: I am most grateful to you, Madam Deputy Speaker, for your guidance. I was merely trying to draw to the House's attention the fact that the number of claimants can be significantly reduced if more and better training support can be given to those who have been on incapacity benefit for a longer period.

David Ruffley: With the leave of the House, I should like to respond to the debate, which has been interesting, important and short. I was particularly interested to hear the remarks made by my hon. Friend the Member for Beverley and Holderness (Mr. Stuart), who reminded us in an interesting and fluent contribution that benefit dependency has been on the increase in the past eight years. People are now on benefits who do not want to be on them; they would rather be in work. He also reminded us that benefit uprating has been conducted more often by Conservatives when in government than by other parties. He stressed that the Conservative party believes in welfare for those who need it—those who, for no fault of their own, need the support of the state and the taxpayer, who is, of course, happy to lend that support—but we need fresh thinking to ensure that those who can work and want to work are given the opportunity to do so and have the obstacles that are in their way removed.
	My hon. Friend also warned about the perils of excessive means-testing, which is on the rise. He also talked about the ongoing tragedy of occupational pension schemes going bust and the consequent increase in the number of pensioners who must rely on benefits to live in dignity in their old age. It was an enjoyable contribution, with some important points, which can also be said of the contribution of my hon. Friend the Member for Ludlow (Mr. Dunne), who drew attention in a technically adept set of remarks to the fact that the tax credit disregard, which has been raised from £2,500 to £25,000, appears to be an uncosted commitment and that he has sought in vain, using the method of asking parliamentary questions, to find out the cost to the Exchequer of that policy change. I really do hope that the Minister can tell us and not shuffle us off to other Ministers at the next Treasury questions.
	My hon. Friend also talked about savings, which are, of course, very pertinent to a debate on benefits uprating. If the savings culture is as damaged as he said—I think that he is right—more and more pensioners must rely on the very benefits that are uprated by the order. He spoke about the need for the Government to find more intelligent savings policies. Those points were well made. He also touched tantalisingly on pathways to work and how benefits recipients might escape from benefits into work. He certainly touched on incapacity benefit reform in an instructive way. He talked about the experience of Holland and the lessons that DWP Ministers might learn—the Opposition are certainly learning them—about active intervention in the labour market to get those who are desperately keen to get off benefit back into work. Although we share the same objective as Ministers, today's debate has shown that the Opposition have radically different solutions and means to achieve that common objective.

James Plaskitt: We have had a short but, nevertheless, lively debate. I have been struck by the fact that the hon. Members who have spoken have found it quite a strain to confine themselves to the orders under consideration. I take it from that that, in fact, they have very little to criticise in the upratings that we are making.
	Before I address any of the specific points made during the debate—I promise to do so—I want to remind hon. Members that this year's uprating order continues the Government's commitment to provide help for those who most need it. After all, it adds more than £3.44 billion of extra spending, £2.58 billion of which goes to pensioners and £360 million is above inflation. Some £40 million goes to children; £400 million to disabled people and their carers; and £420 million to people of working age. Most benefits have increased in line with the retail prices index, at 2.7 per cent., while pension credit guarantee has increased in line with earnings, at 4.2 per cent. Those uprating increases contribute to our programme of radical reform which balances rights with responsibilities and offers everyone the chance to build a decent income for their retirement.
	I turn now to the contributions to the debate. Many of us enjoyed the footwork of the hon. Member for Bury St. Edmunds (Mr. Ruffley) as he tried, in the same sentences, to change, but not change, Conservative policy on the new deal. We heard him describe the Conservatives' approach to the new deal as revamping it, recasting it or improving it. When they have finally sorted that out, we will be interested to hear what emerges.
	The hon. Gentleman also dwelt at some length on the labour market. It is worth just pointing out what the latest statistics show us. Employment has risen by 183,000 over the last year. The claimant count for January, the latest month for which figures are available, went down by 2,000, a welcome drop after several months in which it increased. We have seen a fall of 58,000 in the number claiming incapacity benefit since August 2005, and a fall of 29,000 in the number claiming lone parent benefit. When one excludes students from the figures—it is important to do that because the number of students going into higher and further education is increasing—one sees that the inactivity numbers have gone down by 61,000 over the last year.
	The hon. Gentleman also dwelt at some length on means-testing, seeking to criticise us for that being part of the system, while himself declaring that a welfare state requires an element of means-testing. He referred to the projection in Lord Turner's report that if nothing changed in the current configuration of pensions provision, we could find ourselves with 70-odd per cent. of pensioners encountering means-testing. Lord Turner does say that, but in fairness, the House should acknowledge what he also said about the effectiveness of the means-testing in the system in reducing pensioner poverty. There is an issue about the role and degree of means-testing in the system for the long term, and of course we are reflecting on Lord Turner's point, as are many others, and we will have things to say about that when we come back to the House in the spring with our response to his report.

Graham Stuart: I wonder how the hon. Gentleman reconciles the remarks that he has just made about means-testing with the Chancellor's remark, made when the Labour party was in opposition, that he wanted a significant diminution in the use of means-testing in the British welfare system. Is that an aspiration that has entirely left the Labour party and its Members of Parliament?

James Plaskitt: If the hon. Gentleman waits until the Government respond to Lord Turner's report, he will find that the issue is effectively taken up there.
	The hon. Member for Inverness, Nairn, Badenoch and Strathspey (Danny Alexander) also dwelt at length on Lord Turner's report. He reminded us of the one Liberal Democrat pensions proposal that has so far emerged—the citizen's pension, which is specifically rejected in the report. We will see whether the Liberal Democrats make further proposals in due course.

Danny Alexander: Will the hon. Gentleman give way?

James Plaskitt: No, I want to make headway.
	The hon. Gentleman also dwelt on the issue of fraud and error in the benefits system, describing the recent report by the National Audit Office as critical of my Department in that respect. I urge him to go back and read the report again; it is actually very balanced and fair. Although it certainly takes us to task and says that there is still more that my Department needs to do in respect of fraud and error, it also acknowledges the considerable progress that we have made in tackling them over the last seven or eight years.
	The hon. Gentleman asked me to distinguish between performance on fraud and that on error, and I am happy to do so. Our performance on fraud is very encouraging. Losses to fraud are now below £1 billion, and we think that the figure now stands at less than 1 per cent. of the total spend. That is a creditable performance. On the main benefits that tend to be prone to fraud—housing benefit, income support and jobseeker's allowance—losses to fraud are down by a half since 1997. Of course there is still more to do. We recently published the fraud strategy document, which I am sure that the hon. Gentleman has studied, in which we outline additional measures that we are now taking and additional powers that we have to make even more progress in reducing fraud in the benefits system.
	On error, yes, the figures are flat-lining; there has not been as much progress in reducing losses to error in the system as we would have hoped. We believe that the total of such losses is about £1.7 billion. If the hon. Gentleman has a little patience, I hope to be able to say more about what we can do to make further progress on reducing such losses.
	The hon. Gentleman moved on to be critical of our proposed reform of housing benefit. I think that I heard him describing the local housing allowance as "not radical". Again, I urge him to have a further read of the chapter in the welfare Green Paper. He will find that once the local housing allowance is rolled out nationally in the private rented sector, it will definitely help us to make progress in increasing financial inclusion, something that I should have hoped he would welcome. It will certainly help us make progress in simplifying aspects of the benefits system; I had hoped that he would have welcomed that. It will certainly help us to make progress in increasing return-to-work incentives; and I would have thought that he would have welcomed that. The hon. Gentleman went on to refer to the single room rate. He should know, and I would have thought welcomed the fact, that under the LHA scheme, support for young people is more generous than under the existing scheme. I am sorry that he did not welcome those developments.
	The hon. Member for Beverley and Holderness (Mr. Stuart) treated us to an amusing trip down a selective memory lane on the performance of the economy under the previous Government, and sought to rubbish the record under the present Administration, therefore overlooking the fact that ever since this Government came to office in 1997, there has been continuous growth in the economy, for a longer period than was ever sustained under the Conservatives. We have falling unemployment—it is now at a very low level. We have had steady and low inflation, which was not delivered by the previous Conservative Government. We have low levels of public debt. We have low levels of interest rates.
	The hon. Gentleman regaled us with the alleged failings of this Administration in respect of incapacity benefit, neatly overlooking the fact that when the Conservative Government came to office 700,000 people were claiming incapacity benefit, and by the time they left office, the figure was 2.7 million. It was convenient for him to overlook that. He should note that last year we saw a welcome fall in the number of people claiming incapacity benefit—down by 58,000—and once we bring forward measures that are outlined in the welfare Green Paper, we hope to make considerably more progress by reducing that number even further.
	The hon. Member for Ludlow (Mr. Dunne) sought also to criticise the Government on what has happened to savings. Indeed, one or two other Members made the same point. The savings ratio is quite a volatile indicator and there have certainly been periods under this Government to date when it has been quite low, but I urge the hon. Gentleman to look at the figures under the previous Administration. He will find that at times the savings ratio fell to levels lower than at any time under this Administration. He should know that the savings ratio tends to be very much geared to the housing market, and during periods of high inflation in house prices we see the ratio plummet. When the housing market stabilises, we see the savings ratio recover. Interestingly, that is exactly what it is doing again, as the latest figures confirm.
	The hon. Gentleman also made some sensible observations, which I welcome, in respect of the Turner report. He urged us to think carefully about the advice that is given to people and about confidence in the system, and he made constructive and sensible comments. I appreciate the work that he does on the Work and Pensions Committee, as I do his comments about the Dutch experience and the importance of undertaking reforms that focus on people's capacity to work and not on their incapacity to do so. I would claim that that is very much the direction of travel of the Government's reforms.
	Since 1997, the Government have worked to build a modern, active welfare state. There are now 2.3 million more people in work and 1 million fewer people on benefits. We have lifted 2 million children and almost 2 million pensioners out of absolute poverty. We have already taken action to replace the "one size fits all" model of benefit dependency with an active service, where tailored support to help people back into work is matched by their obligation to do everything possible to help themselves.
	It is because of the economic decisions that we have made and the reforms that we have delivered that we are making good progress in tackling the challenges apparent in the labour market, but we need to do more. As my hon. Friend the Minister for Pensions Reform said in opening the debate, we need to provide a welfare state that enables people to move on and to escape poverty, rather than institutionalising dependency. That is why we have set ourselves the ambitious target of an 80 per cent. employment rate.
	Our approach is based on a belief in an active welfare state that balances rights and responsibilities, and provides work for people who can work and support for those who cannot. That strategy is set out in the Green Paper and is threefold: we will endeavour to reduce the numbers of new claimants; we will provide greater help for those on benefits to return to work; and, for the most severely sick and disabled, we will provide greater levels of support. The publication of the Green Paper marks the start of a three-month consultation process. We will listen very carefully to everyone who responds and especially to those who share our commitment to improving the employment prospects of people currently living on benefits.
	The Government are committed to supporting parents not only in achieving their ambitions in the workplace but in carrying out their parenting responsibilities. This year's uprating order directly benefits the poorest families and helps to eradicate child poverty. By increasing the child allowance for families on income-related benefits, our uprating measures maintain our commitment to, and progress towards, a fair, inclusive society with opportunity and autonomy for all.
	This year's uprating order takes us another step away from the shameful legacy of pensioner poverty that we inherited. Many pensioners were expected to live on as little as £69 a week. My hon. Friend the Minister for Pensions Reform set out at the opening of the debate the pensions policies that we have introduced. Through measures such as pension credit, the state second pension and stakeholder pensions, we have provided a solid basis for a long-term pensions settlement and lifted nearly 2 million pensioners out of absolute poverty. An extra £10 billion will be spent on pensioners in 2006–07. Almost half of that extra money will go to the poorest third of pensioners.

Danny Alexander: Does the Minister accept that all the things that he has just described depend fundamentally on pensioners and benefit recipients being able to access those benefits in the first place? Does he agree that the Government's decision on the card account will severely undermine people's ability to access the benefits that are being uprated? Will the Government consider reversing that decision to enable full access to benefits for all the people who currently access them through their local post office?

James Plaskitt: The hon. Gentleman again seeks to assert that there has been a recent decision or change of policy, but there has not. I repeat the commitment that we have given many times before that if pensioners and benefit recipients choose to collect their income from the post office we want to ensure they are able to do so.
	We need to do more to meet the demographic, social and economic challenges that we face today. The Pensions Commission was clear that there is not a pensions crisis, but it identified about 9 million people who were not saving enough for their retirement. That, together with the demographic challenge of increasing life expectancy, would lead to a crisis in 20 or 30 years' time if we failed to make appropriate responses now. That is why we established the Pensions Commission to provide a reliable, independent review of the UK pension system and to make recommendations for change.
	We are expanding the national pensions debate and talking to people of all ages across the country to listen to their views. We want to involve citizens and stakeholders in developing a lasting settlement on pensions. We will hold a number of events that will culminate in national pensions day on 18 March. The findings will help us to develop a consensus-based package for reform. I believe that building such a consensus is crucial. We want to ensure that the decisions that people make in the next few years about savings for retirement will still be sensible choices in 20, 30 or even 40 years' time.
	The Government have undertaken their own rigorous analysis of the commission's proposals. The package of reforms that we will introduce in a White Paper in the spring will satisfy the five tests that my right hon. Friend the Secretary of State has set out to promote personal responsibility, and be fair, affordable, straightforward and sustainable.
	In conclusion, the uprating order further delivers on our promises to help the people who need it most, supporting families and tackling the poverty suffered by pensioners and children wherever it occurs. We are supporting more people who can work into work, including people on incapacity benefit and lone parents. We are helping older people who want to return to, or remain in, the work force to extend their working lives. We are ensuring dignity and security for pensioners, as well as an end to abject poverty in retirement. For those reasons, I commend the orders to the House.
	Question put and agreed to.
	Resolved,
	That the draft Social Security Benefits Up-rating Order 2006, which was laid before this House on 25th January, be approved.

PENSIONS

Resolved,
	That the draft Guaranteed Minimum Pensions Increase Order 2006, which was laid before this House on 25th January, be approved.—[Mr. Timms.]

Tackling Health Inequalities

Motion made, and Question proposed, That this House do now adjourn.—[Caroline Flint.]

Caroline Flint: It gives me great pleasure to open the debate on inequalities in health. Over the past 50 years we have seen impressive social, economic and health improvements in the United Kingdom. People from every class and every region are healthier and are living longer than ever before. The differences over time are striking. For instance, data for 1972–76 show that male life expectancy in the lowest social group was 66.4 years. That compares to a life expectancy of 71 years by 1997–2001. That is an indication that public health policies are having an effect on people's lives, as are treatment and new drugs.
	However, the Government are not complacent. We need to do more about inequalities. We know how to improve life expectancy, but we need to ensure that all parts of society are benefiting. We know that families in poorer neighbourhoods are at greater risk of infant mortality, still die at a younger age and are likely to spend more of their lives in ill health. A man living in Manchester is likely to die nine years earlier than one living on the south coast of England. We know, too, that a man working as a manual worker in a factory is a third more likely to report a long-standing illness, compared with a man in a professional group, such as a doctor or a lawyer.
	Social injustices like those are what brought me and many of my colleagues into politics, and are one of the reasons why we have given health inequalities a high priority now that we are in government. From the beginning, we were keen to set the record straight. One of the first things we did was to commission a comprehensive inquiry into the evidence on health inequalities. We invited a former chief medical officer to chair the inquiry. The result was the Acheson report, published in 1998. Acheson showed a significant widening of health inequalities between the 1970s and 1990s. The differential had increased two to three times between the highest and lowest social classes. It could be addressed only by focusing on the wide range of determinants—social, economic and environmental—that have an impact on health.
	Acheson focused on programmes and priorities, but targets are important to focus attention on the problem, to stimulate action and to engage key players. In 2001, we set a national health inequalities target for England that called for a 10 per cent. reduction in the health gap for life expectancy and infant mortality. We extended this approach by including health inequalities as part of our key targets on heart disease, cancer and smoking. We have used the adoption of national targets as a way of influencing and shaping policy across the Department of Health, the health service and, importantly, other Government Departments, too.
	In our target on smoking—the biggest cause of avoidable deaths—and our work to reduce smoking levels, we recognise that we cannot achieve our overall goal to reduce smoking levels without focusing on the hard-core group of poor smokers. Clearly, the decision of the House to ban smoking in all public places apart from a few exemptions, which was supported by Members from all parties, will make a huge contribution to tackling the problem, and took account of the concerns about health inequalities caused by partial restrictions on smoking in public places, particularly licensed premises.

Crispin Blunt: The hon. Lady ought to concede that it was the view of the House on a free vote that overrode the policy of her Department that was presented to the House on Second Reading—a policy that would have promoted health inequalities resulting from smoking.

Caroline Flint: As I said in the debate, the opportunity that we had to vote came about because Labour decided that we should legislate on the matter. I am pleased that there was a debate. It was healthy for democracy. It is a Labour Government who are doing more than any Government before to tackle the problems of smoking and the effects on others who do not smoke.

Andrew Lansley: I get the impression that the hon. Lady might be moving away from telling the House in simple terms what has been the result thus far of the two national targets relating to life expectancy and infant mortality.

Caroline Flint: I intend to cover those issues, which are very complex. [Interruption.] Well, they are complex. The reality is that everybody from every social group is making progress in terms of their life expectancy. Our problem, which I am certainly not afraid to face up to, is how we deal with a situation whereby although everybody is living longer and improving their health, people who are better off and more educated take up the challenges of improving their health more quickly than those who are less well off and less educated. That is one of the reasons why we have to deal with the gap, of which I am fully aware.

Graham Stuart: rose—

Ann Winterton: rose—

Caroline Flint: I should like to make a little progress in the hope that I will deal with some of the points that the hon. Gentleman and the hon. Lady may make, but I will be happy to take interventions if I do not.
	Following the adoption of the national target, health inequalities was chosen as the subject for a cross-Government review led by the Treasury. That review was designed to influence spending decisions across Government as part of a wider programme to address child poverty and promote social justice. Jointly chaired by the Department of Health and the Treasury, it brought together 18 Departments—from Department for Work and Pensions to the Department for Transport—and Government units and agencies. Together, they assessed progress and agreed priorities for action. For us, the role of the Treasury provided the catalyst for this cross-Government work and a new national health inequalities strategy.
	That strategy—the programme for action launched in 2003—sets out four themes to tackle health inequalities: supporting mothers, families and children; engaging with mothers, families and children; preventing illness and providing effective treatment and care; and, importantly, addressing the underlying determinants of health. Those four related themes set out a programme to address health inequalities on a broad front, directed to the whole population and designed to ensure that responsibility for tackling health inequalities lies at the heart of all public services. That includes work on urban and neighbourhood renewal and on giving children from poorer families a fairer start in life through Sure Start. As well as focusing on the 2010 national target, the strategy seeks to address some of the underlying causes and determinants of health such as employment, education, crime, transport, early years support and homelessness. Our aim is to improve everyone's health, but to improve the health of the poorest fastest.
	People living in disadvantaged areas usually have much lower expectations of the health care system and of their own health. On a recent visit, we met a 49-year-old man who, despite breathlessness, did not think that he was unwell. He said, "I'm not ill—I'm just getting old". Yet he was not even 50. Here we are in Westminster, where a man will most likely live until 76. If we travelled east on the Jubilee line to Canning Town, eight stops away, we would find that on average men live until 69—a seven-year difference. A shorter life expectancy means that families are robbed of parents and grandparents. Between 2002 and 2004, there were 13,700 additional deaths among 30 to 59-year-olds in the most deprived local authorities compared with the rest of England.
	The status report on the programme for action published last August showed encouraging signs of progress on health inequalities, but recognised that a significant challenge remained. Following that report, we decided to commission a review of health inequalities, which was undertaken in conjunction with the Treasury. The review signalled a conscious decision to improve our performance and to ensure that we use the available evidence base to meet our targets. We have developed a model to deliver real improvements in public health in the short term that concentrates on averting early death. The model identifies the age groups we need to focus on—the 40 to 60-year- olds—the most common causes of early death, and the most effective treatments and interventions we can apply to prolong life.

Ann Winterton: The Minister is talking about equality of opportunity in health. Will she say a word about the inequalities in the postcode prescribing of Herceptin? Having had a constituency case in which we fought for a young woman to be given that treatment, it was obvious that people living two miles down the road in another area had it as of right. What equality was there between those two examples?

Caroline Flint: We have clearly said and maintained that individual clinicians should consider with patients whether drugs such as Herceptin are an appropriate treatment choice, taking into account risks and medical history. We have also said that primary care trusts should not rule out treatments on principle, but should consider individual circumstances when reaching decisions and that they should not refuse to fund Herceptin solely on the ground of cost.
	I am pleased to say that we have seen some huge improvements in other areas of cancer treatment in the past seven to eight years that have been of benefit to many people suffering from many different types of cancer.

Andrew Lansley: It would be courteous to my hon. Friend the Member for Congleton (Ann Winterton) to find out precisely what Government policy is. Clearly, primary care trusts in different parts of the country reach different decisions about whether they will fund Herceptin for breast cancer patients on the basis of their judgment of the clinical case rather than that of individual clinicians. Do the Government think that that is the right way to proceed? Do they accept that different decisions should be made in different parts of the country about an issue where a clinical judgment could potentially be made on a national basis?

Caroline Flint: It would be inappropriate to direct PCTs to have a standard position on a drug that is not yet licensed or appraised. The PCTs have the opportunity to make choices about their policy on that particular drug and we have made that clear. As with many such matters, PCTs should deliver what they think is right for their local communities and should take into account clinicians' advice as well as other issues, such as guidance from the National Institute for Health and Clinical Excellence.

Andrew Lansley: It is a simple point. It is perfectly logical for the Government to have said that PCTs must make a decision on an unlicensed drug, but why did the Secretary of State interfere? Why did she say such things if her intention was not to send a message that Herceptin would be available for early stage breast cancer?

Caroline Flint: I think that I am correct in saying that the Secretary of State was pointing out that cost was not the only factor that should be taken into account. Clearly, individual cases have to be suitable and other matters apply.
	I want to return to my point about the major reasons for people dying an earlier death than we would hope. For example, circulatory diseases and cancer are responsible for approximately 50 per cent. of avoidable early deaths. Logically, it would be correct to focus on treating those diseases. However, as I said before, we should also target the underlying causes of ill health. Unemployment, the absence of support in early years, housing conditions, homelessness and other contributing factors mean that some individuals are more likely than others in their community or elsewhere in the country to suffer ill health.

Graham Stuart: The Minister will be aware that poorer people in rural areas are statistically invisible, struggle to access services and are disproportionately affected by closures and cutbacks at community hospitals. If the Minister believes in reducing health inequalities, will she reverse the ongoing cuts to community hospitals and make the welcome rhetoric of the White Paper a reality?

Caroline Flint: The hon. Gentleman is right to make the point about challenges in rural areas, particularly for those who might not have transport or who have low incomes. That is why health inequalities have to be tackled not only in urban areas but in other communities, and why programmes such as neighbourhood renewal funds are important.
	On the hon. Gentleman's point about community hospitals, I cannot comment on his remarks about reversing cuts. One of the challenges is to meet the health needs of families, neighbourhoods and communities that are not getting the much closer and more personal health service that could make a difference and motivate them to consider aspects of their lifestyle that might affect their later years. One way of meeting that challenge is to examine the way in which some services could be provided closer to home.
	My right hon. Friend the Secretary of State has said in recent debates that in areas where community hospitals or cottage hospitals have been identified for closure, it is important that the people involved in the planning arrangements take a hard look at the ways in which those hospitals could be refashioned or reorganised to provide services in the different ways suggested in the White Paper. I have taken part in a few Adjournment debates on this subject, and I am aware that some of the services being provided by the community hospitals are not necessarily the ones that most meet the needs of their community. It is important, whether in community hospitals or acute hospitals, to consider what is being provided and whether it meets people's needs. I hope that I have given the hon. Gentleman a full answer to his question.

David Drew: May I say that my hon. Friend has got this absolutely right? One of the problems with rural areas is the disproportionate effect of funding being spread across the whole area and missing the pockets of real deprivation. This is made clear by the way in which some general practices operate. Will my hon. Friend take it from me that the best way to deal with this is—to use a horrible expression—to drill down and find out what the social and medical problems are in rural areas, and disproportionately to fund the people and places in greatest need? It is not fair that, too often, those people miss out because they do not have a voice. We hear the rhetoric that the funding is going to those people, but the reality is that it is not.

Caroline Flint: My hon. Friend makes an important point. One of the things that we can do at national level, in identifying this problem, is to ensure that the organisations that commission and provide services demonstrate how they are meeting the targets on health inequalities through the services that they provide and through the outcomes of those services. That is one way of incentivising local service providers, commissioners and GPs to understand the nature of the problems experienced by some of the people in their communities, and to look in different ways at the services needed to help us close the gap created by these inequalities.

Philip Hollobone: In north Northamptonshire, alcohol misuse is becoming an increasing problem. Is tackling that problem moving up the Minister's list of priorities?

Caroline Flint: It is certainly there, along with a number of other issues, such as obesity and smoking. Alcohol is an interesting subject because there is evidence that its misuse takes place across different social classes. Yes, it is a problem for those in our poorest communities, but also for those who are better off. I am having discussions with the Ministers responsible for these matters in the Department for Culture, Media and Sport and the Home Office, and we are working with Ministers in the Department for Education and Skills on alcohol education in schools. We are also engaged in discussions with producers and retailers in the alcohol industry about what further information they could provide on packaging to inform people about safe levels of drinking. There is lot that we need to do to get people to understand the dangers. They might not think that they are drinking at an unsafe level, but, over time, they could develop real problems. This is an issue for young people, some of whom could have considerable health problems by the time they reach 30, if they do not reflect on the amount that they are drinking.

Several hon. Members: rose—

Caroline Flint: I shall give way to my hon. Friend the Member for North-West Leicestershire (David Taylor), then to the hon. Member for Torridge and West Devon (Mr. Cox). Then I would like to make some progress.

David Taylor: I am grateful to my hon. Friend the Minister for giving way. One of the proudest achievements of our Government since 1997 is the establishment of the post of Minister with responsibility for public health, and a very successful one we have today, particularly in view of what happened earlier this week.
	My hon. Friend has outlined a number of the significant gaps—between urban and rural areas, social classes, age groups, geographical areas and so on—but perhaps one of the most fundamental is a man-woman split. Will she say a little about the inequality that exists there in terms not only of the natural tendency of the male not necessarily to report or monitor his own health, but in some of the most fundamental diseases of all? An awful lot of investment has rightly gone into breast cancer, but less has gone into testicular and prostate cancer, where the outcomes for that extra £5 million, £10 million or £15 million would be even better. This is a difficult one, but what is she doing about it?

Caroline Flint: I am involved in a great deal of work with organisations such as the Men's Health Forum to consider how we can encourage men to think about their health, and we are also considering innovative ways to use pharmacies and others to reach hard-to-reach groups whose members often do not come into GP surgeries. I understand that men are particularly guilty of that.
	We are looking at other venues where it might be possible to get men to think about their health. For example, we have done some fantastic work with the Football Association and some good work is going on in football clubs up and down the country to engage men. Although men exclusively do not go to football, that is one way we can reach them.
	I would like to say something further on the issue around gender, so I will come back to the hon. Member for Torridge and West Devon later. While we obviously need to look clearly at gender differences, there is some concern among women—we might be seeing some trends, as more women seem to be drinking more alcohol and smoking rates among women are also considerably high—that we need to address health issues arising from the change over the past 20 or 30 years in terms of taboos that existed for my grandmother and for my mother over women's lifestyles. I am not saying that that was all right or that it was rather judgmental, but there are consequences. We are seeing, because of that, some evidence that issues that were often seen as male health problems are starting to emerge among women as well. We must consider how best to deal with that too.

Geoffrey Cox: On the point relating to rural areas, does the Minister agree that the national weighted capitation strategy is plainly inherently biased towards urban areas? Its assessment of additional need adopts indices that are clearly not applicable to poverty in rural areas, to which the hon. Member for Stroud (Mr. Drew) referred. If it is inherently biased, and if the best method of capturing need in rural areas is being systematically missed, there will be increasing health inequality in rural communities. Is not that something that the Government should deal with urgently, and what is the Minister going to do about it?

Caroline Flint: The basis of funding to primary care trusts is determined on levels of need and issues around population are taken into account, but this is an area that we keep under review. To give an example from my constituency, which is semi-rural as it contains mining villages, we have benefited from money we got through the rural bus grant to have bus services provided for some of our outlying villages. That has given many people an opportunity to reach some of the services in Doncaster. That provision has helped and it is a good example as it involves health in terms not only of rural areas, but of how other Departments and those agencies closer to where people live—whether the local authority or the strategic transport executives—take these issues into account. The regional development agencies also have a role to play in looking at supporting infrastructure in our rural communities.

Andrew Lansley: This is an interesting point. Does the Minister agree that using ward-based data in relation to deprivation in rural areas such as her constituency might indicate high levels of deprivation there, while in many other rural areas such data do not do so because smaller numbers of relatively poor people are hidden by larger numbers of relatively wealthy people? One method of dealing with that is for the national health service in particular, given that it is building up through GPs an enormous database of morbidity—knowing how many asthmatics there are, knowing how many diabetics and the like—to transfer from assumed to real data.

Caroline Flint: Data are important for planning and commissioning. I have had interesting discussions about how some GPs are breaking down their practice areas, not just on a ward basis but street by street, to target services on those who are most in need, rather than getting in touch with everyone. Some exciting work has been done in rural and urban areas. For example, particular ethnic minorities have been targeted, because of certain health needs, to good effect. One of the Department's challenges is how to enable those who commission and plan services to use social intelligence better to construct services and gain better value for money through more precise targeting.
	I am sure that the hon. Member for South Cambridgeshire (Mr. Lansley) would agree that, having given record funding to the NHS, our challenge is to demonstrate that best value for money is being achieved. My right hon. Friend the Secretary of State visited Dudley the other week where better-quality services are having much greater impact and better outcomes, from less money, than the old services used to provide. I visited a sexual health clinic off the Tottenham Court road only last week, which provided good examples of changing the way in which services are provided to improve access and save money. There is a 48-hour waiting time target for those services, which is challenging but which some providers are meeting. It is an exciting area, and those who are planning and want to provide services need to think about how to reach people in a more targeted way. If they do, we will have a much greater opportunity to close the health inequalities gap.

Crispin Blunt: Does the Minister agree that the gist of what she is saying is that the best way to address health inequalities, particularly those produced by social deprivation, is through first-class primary care services and community care hospitals, whereas the elderly population are more likely to need access to good critical care services? Does she accept that that is a reasonable definition?

Caroline Flint: In tackling health inequalities, it is critical to be clear which are the most vulnerable groups in the local community when it comes to suffering ill health. It is then a question of identifying the core components leading to those poor health outcomes. As to whether that is partly about changing what happens in the acute sector, there is probably room for improvement in hospitals. Provision in community hospitals is also part of the debate. But there are two other aspects. First, prevention can stop people getting ill in the first place or reduce illness. Secondly, people are living longer because technology has moved on and drugs are better, which is welcome—more people are surviving heart attacks and cancers. The question of provision for more long-term management of illnesses follows from that. Whether it should be done in hospital or in the community is open to debate. It is extremely important, however, that we consider outcomes, focus on what we are attempting to deliver and show clearly that what we are doing works. We need to be as robust in arguing for the activities that we encourage and support, especially in the context of public health, as are those in the clinical sector when it comes to operations and medicines.

Siobhain McDonagh: Does my hon. Friend agree that although the average 65-year-old has more health needs than a younger person, some over-65s are very healthy? Average life expectancy in East Elmbridge and Mid Surrey is over 81, nearly 10 years higher than the average life expectancy for men in Cricket Green in my constituency. If we want to reduce health inequalities, should health services be concentrated where there are healthy 70-year-olds or where there are people 10 years younger whose health needs are far greater?

Caroline Flint: My hon. Friend is right. As I have said, life expectancy is much lower in some parts of the country and in some parts of communities than it is elsewhere. I am pleased that many people are taking action to improve their health, and that should be encouraged. We should do as much as we can through the NHS to help people to help themselves and to make the right choices. We must also bear down on health inequalities, however, and recognise that they are not a case of "One size fits all". We need a much more targeted and focused way of addressing health inequalities among those who are most in need. We must direct services to their communities, so that they can be taken up easily. That will enable such people to change their lives in the same way as other, healthier people elsewhere.
	We have recently added health inequality targets to our other health targets and incorporated them in the business of the NHS. As a number of Members have pointed out, the issue of health inequalities cannot just be tagged on to the work of the NHS; it must underpin that work. Our targets on heart disease, cancer and smoking now automatically include elements to reduce the health gap. I am pleased to say that we have already seen a 24.7 per cent. reduction in the heart disease gap, and a 9.4 per cent. reduction in the cancer gap.
	Local action is the key to delivering our national programmes throughout England. That means engaging with local delivery partners such as local government, the local health service, the voluntary sector and community groups. Through improved NHS funding and the measures specified in "Choosing Health", the most disadvantaged areas, covering 28 per cent. of the population of England, received extra support and money to help them to tackle health inequalities. Those steps must be supported by measures that identify and reward performance and by other incentives that encourage action in both health and local government services.

Andrew Lansley: Will the Minister give way?

Caroline Flint: I have already accepted a number of interventions, but if I make enough progress I may give way to the hon. Gentleman later.
	Health inequalities exist everywhere, but we continue to emphasise the importance of making faster progress among the most deprived groups. We have therefore identified the 70 local authority areas with the worst health and deprivation indicators—the spearhead group. That epitomises our targeted approach and allows the creation of innovative public health programmes, such as the healthy schools programme and the provision of health trainers. Services are being tailored to the needs of local communities, and barriers to healthy living are being removed.
	Local government is a key partner. We have agreed with local government a shared priority for healthier communities and reduced health inequalities. For the first time local authorities will be assessed, as part of the comprehensive performance assessment, on the action that they are taking to reduce health inequalities. The ongoing local area agreement process has enabled local authorities to embrace the agenda in their areas with enthusiasm. The White Paper offered the opportunity for more joint appointments of public health directors and for joint commissioning. We have recently made dealing with health inequalities the first of six top priorities for the NHS and have signalled our commitment to performance-managing the NHS more closely. We are also sharing best practice in areas that are delivering with those that are under-performing.
	Government programmes to tackle child poverty and bring about neighbourhood renewal form an integral part of our strategy, but we also need to empower individuals to seize responsibility for their own health by improving socio-economic factors, thus giving them a reason to live and helping them to change their lifestyles. In the "Choosing Health" White Paper, we introduced health trainers—a new type of personal health support. They will be visible and accessible to local people, living and working in the communities they serve and providing "support from next door". We have engaged with nearly half the NHS to deliver, from April 2006, NHS health trainers in the areas of highest need. Having listened to people's concerns, we responded by announcing in the recent White Paper—"Our Health, Our Care, Our Say"—our intention to introduce NHS "life checks" at different points in people's lives.

Andrew Lansley: I am grateful to the Minister for giving way, because this is precisely the issue on which I wanted to come in earlier. She is right to say that interventions must be rigorously examined in the same way as clinical procedures, which is one reason why the National Institute for Health and Clinical Excellence has taken over responsibility for such matters from the Health Development Agency. She will of course be able to quote the evidence that points directly to the need to appoint health trainers and to provide the life checks outlined in the recent White Paper.

Caroline Flint: The work on health trainers was developed by talking to those on the ground about how we can engage people who are not presenting themselves to services in the traditional way. We have asked—[Interruption.] I shall finish my sentence, if the hon. Member for South Cambridgeshire will allow me. We have asked different areas of the country to provide information on such services, and we will evaluate their impact. [Interruption.] Both the life check and health trainer initiatives emerged from the White Paper consultation process. We will establish an expert stakeholder group, which will examine how the initiatives will work.
	This is not about adding more checks—there are already opportunities for different checks—or adopting a one-size-fits-all approach; nor is it just about sickness: it is about health and finding a practical, non-burdensome way of engaging with people at different points in their life and getting them to think about their health. [Interruption.] For some people, relatively little action will be required. Many will be able to carry out a self-assessment and will need nothing more. But for others, a health check might be the spur for health providers to think about the services that they should provide, and for the individual to consider how their lifestyle is affecting their future health.

David Taylor: Is it not a bit much to have a constant stream of chuntering from Conservative Members while the Minister describes these initiatives? When they were in government, they denied the link between poverty and ill health. They suggested that elderly people should respond to fuel poverty simply by putting on an extra cardigan, and that people in northern constituencies such as hers should respond to an increase in the incidence of heart disease and other such illnesses by eating fewer chips. That is a very constructive and helpful public health policy, is it not?

Caroline Flint: No, it is not. In fact, under previous Conservative Administrations the term "health inequalities" was not used; instead, the Department was expected to use the phrase "variations in health".

Neil Turner: My constituency has a four-star authority, a three-star primary care trust and a three-star hospital trust. However, social services are seriously underfunded and the PCT is £10 million below its target figure. I realise that you recognise the problem of health inequalities, but can you indicate—

Mr. Deputy Speaker: Order. I gently remind the hon. Gentleman that he must use the correct parliamentary language when addressing a fellow Member.

Neil Turner: I apologise, Mr. Deputy Speaker. What action will the Minister take to ensure that the funding inequalities experienced by the PCT itself and in its work with the local authority are addressed?

Caroline Flint: In areas where there is deprivation and various problems associated with a sizeable older population, the funding provided to local authorities and PCTs has taken such factors into account. However, there are opportunities for PCTs and local authorities to work more closely, and that needs to happen. We must also look at where resources are being directed, and decide whether they could be used differently to achieve better results. There are various good examples around the country of money being used better and achieving better outcomes. We do not micromanage the NHS from the centre, thank goodness, but we can give an oversight and provide access to the best information about what works. People like my hon. Friend and other colleagues will be able to use that information to ask their PCTs and local authorities why a system that produces results in other parts of the country is not being used to meet the challenges elsewhere.
	I absolutely believe that it is very important not to underestimate the challenge posed by health inequalities. Our life expectancy target is deliberately challenging. We faced two problems when we set it—halting and then reversing a long-term trend. There is still a huge amount of work to be done, but I believe that the target is achievable, and am pleased to say that there are signs of positive change.
	For example, 60 per cent. of the spearhead areas are making progress towards meeting the target and narrowing health inequalities. Of the 70 local authorities, 29 are on track to meet either the male or female elements of the target, and a further 13 are on track to meet both.
	However, health inequalities are stubborn, persistent and difficult to change. Change will take time, but in our health and equality strategy we have identified a range of headline early-warning indicators, and other indicators. The most recent assessment of progress is set out in our status report published last August. Our latest robust data are for 2003, although of course work has been done since then. The figures show that health inequalities in respect of infant mortality and life expectancy were still widening, in line with the long-term trend. However, there are encouraging early signs of progress in key areas, such as reducing child poverty, improving housing quality and reducing inequalities in circulatory diseases.
	As I said earlier, death rates from heart disease and strokes are falling. Importantly, the absolute gap between disadvantaged areas and the country as a whole has fallen by more than a fifth—22 per cent.—in the past six years. For example, a more targeted approach to tackling health inequalities among South Asian groups in Sheffield achieved a faster decline in heart disease mortality in deprived areas than in the rest of the city. The figures were 23 per cent. and 16 per cent., respectively.
	We recognise that black and minority ethnic people experience inequality in health outcomes and in other social determinants of ill health. Therefore, we must also look at what is happening in our black and ethnic minority communities to make sure that the service is sensitive to the needs of the people who live there, irrespective of gender or ethnicity.

Charles Walker: The Minister is being very generous in giving away again, but does she agree that mental health is one of the greatest areas of inequality? The high-profile areas such as heart disease and cancer get a lot of coverage and support, but mental health is almost forgotten and seems to lag behind. What message will she give me to take back to my charities in Waltham Cross and Cheshunt concerning the support that the Government will give to help them deliver services that are critically important?

Caroline Flint: The hon. Gentleman makes the very valid point that people who suffer from mental health problems often have other health problems that need to be attended to. They deserve to be focused on as much as anyone else in the health agenda, in terms both of prevention and of the provision of better services to meet their needs. However, we must ensure that other service providers—of housing, employment, education and so on—look hard at the different challenges that different groups face. As was mentioned in the debate the other week, people with mental health problems should certainly be able to feel that they have a right to be heard by those who provide other services.

Rosie Cooper: I agree with the hon. Member for Broxbourne (Mr. Walker) that some groups are denied access, with a resulting increase in health inequality. My example, which is analogous to the mental health example, is disability. My parents are deaf and from the age of four I used to do all the interpreting at any medical consultation that they had. The Government have done a tremendous job in tackling health inequalities—[Interruption.]

Mr. Deputy Speaker: Order. The hon. Lady is making a legitimate intervention. Perhaps she can make her point quickly.

Rosie Cooper: Thank you, Mr. Deputy Speaker. My point was that providing interpreting services or enabling teletext subtitle services on televisions help to get people such as my parents into hospital. My dad needed treatment, but when I arrived four hours later he was dressed to go home because he was bored and could not talk to anybody.

Caroline Flint: My hon. Friend makes an excellent point, sharing the experience of her parents who had hearing problems. When we identify services and needs, it is important that we engage with people such as my hon. Friend's parents to talk about their needs, instead of just assuming that we know best, we will provide something and patients will have to lump it. That is not what people want from their health service. If handled properly and correctly, such engagement will provide savings, as well as better health outcomes. If we do not do that early, we could be storing up an expensive problem for later down the line.
	I have been frank about the fact that there is more to be done in tackling health inequalities. We have set ourselves a challenging agenda, but we are committed to delivering it so that every citizen, regardless of where they live, their social class, ethnic group, disability, or any other challenge that they face as individuals, can expect the same opportunities for—even if they may be delivered in different ways according to their needs—and expectations of, good health.

Andrew Lansley: I am glad to have the opportunity to follow the Minister and contribute to this debate. I thank the Government for making time available for it. It may be at the periphery of parliamentary time, but it is on the Floor of the House and we appreciate that. I am not sure how long it has been since the subject of tackling health inequalities has been debated. The Minister did not say that it was the Government's intention to have regular debates on the issue, but I hope that it is. It is certainly one of the priorities that my right hon. Friend the Member for Witney (Mr. Cameron) set out for us at the beginning of the year.
	It was the Government's intention to publish an annual status report on health inequalities, but the first report took two years. They said in July 2003 that the Department of Health would publish an annual report on health inequality indicators, related to the health inequality targets. The first was published in August 2005. A letter in the British Medical Journal in September described its publication as Labour's Black report moment, because it had been buried in the middle of August. Why did they do that? For the same reason that the Minister did not give the figures when I invited her to tell us the changes in the two national targets identified by the Government for measuring health inequalities. I do not see why not, because as she explained, the point of national targets is to focus people's attention on them, so it does not make much sense to publish them at a time when people will not notice them. Equally, if they are going in the wrong direction, the Government should be rigorous about what they will do to deal with that.
	The figures are straightforward. The relative gap in life expectancy for men has increased by nearly 2 per cent. and for women by 5 per cent. The latest figures on infant mortality confirm the previously reported trend. Despite overall improvements, the relative gap between the routine and manual groups and the population as a whole has widened over recent years, since the target baseline. The overall infant mortality rate was five deaths per thousand live births, while the rate for those in routine and manual groups was six per thousand. In 2001 to 2003, the infant mortality rate in the latter group was 19 per cent. higher than in the total population; it was 16 per cent. higher in 2000 to 2002 and 13 per cent. higher in the baseline period, so the relative gap has widened—from 13 to 19 per cent.
	The Minister said that it was important to look at the finer detail, but the detail she referred to showed things going in the right direction. However, the infant mortality rate among sole registrations—births registered only by the mother—rose to 7.4 per thousand live births, compared with 6.6 per cent. in 2002. In 2003, the mortality rate in the routine and manual social group rose to 6.1 per thousand, compared with 5.8 in 2002—an absolute rather than a relative rise in that one-year period.

Graham Stuart: Have not the Government failed to deal with health inequalities and is not that why they did not meet their promises? Does my hon. Friend agree that the Minister should tell the House that that will not happen again? If the Minister's top NHS priority truly is to tackle the appalling gap between the poorest and the better-off in our society, she must set targets and meet them, and report to the House not annually but every six months. That is what she should do, rather than giving us waffle and rhetoric, while people at the bottom of our society are all too often let down by the Government.

Andrew Lansley: I am grateful to my hon. Friend. In a nutshell, the burden of what I wanted to say is that, if one is to deal with health inequalities, it is vital to focus on the relative gap between the most and least healthy, and between the richest and the poorest. It is not good enough to elide aggregate progress and relative failure. For example, the Minister—as Ministers always do—talked about the absolute reductions in mortality from cancer and coronary heart disease, on a trend that I am sure she will not deny was pretty well established in the latter part of the 1970s for coronary heart disease and the early 1980s for cancer.
	The point is that in all such trends we need to look at mortality rates and find the real inequalities. We may be making considerable progress on cancer treatments, but the relative gap may be widening. At the same time, there are many deaths from lung disease, which the Minister did not mention. The British Thoracic Society tells us:
	"There are three times as many deaths from respiratory disease that are associated with social inequalities . . . than there are cancer deaths that are associated with social inequalities".
	Social inequality in respect of the incidence of respiratory disease is much greater than that in respect of cancers. There is a gap. Eight times more deaths—3,800—are caused by respiratory disease as a result of social inequalities compared with the impact of such inequalities on coronary heart disease, which results in 500 deaths. The Minister did not mention this, but if people are talking about relative mortality rates and the things that bear on them to the greatest extent, they spend more time referring to lung disease than to cancers and coronary heart disease respectively.

Kevan Jones: I am impressed by the hon. Gentleman's conversion and that of the right hon. Member for Witney (Mr. Cameron) to noting the policy importance of this issue—something that has been ignored in the past. If he and the right hon. Gentleman are so committed to tackling this issue, will he support the extra funding that the Government have put into doing so? Will he also support directing extra funds to places such as North Durham and Easington in County Durham, which have some of the greatest problems with health inequalities? Would a Conservative Government support us if other hon. Members and I asked for extra money to go there, rather than to the leafy suburbs that many Conservative Members represent?

Andrew Lansley: I am not quite sure what evidence the hon. Gentleman has to back the idea that I have somehow been converted. If he goes back, for example, to before the general election to the opportunity that I took in September 2004 to set out our policies on public health, he will find that one of the first things that I did was to say that that was our top priority. I said—and I would have done it—that if I had become Secretary of Sate after the election, I would be Secretary of State for Public Health and when we debated health inequalities, the Secretary of State would be here, not an Under-Secretary of State. I made it clear that that focus on public health was intended to improve not just health outcomes for the whole population.

Kevan Jones: Will the hon. Gentleman give way?

Andrew Lansley: No. The hon. Gentleman will have to sit down.
	The intention was not only to improve health outcomes in the whole population, but to increase the relative health of those who are poorest. Why did the Minister not just get up and say what the objective is? We agree that the objective of our policies is to improve the health outcomes of the people of this country and those of the poorest fastest. Why did the Minister not say that?

Caroline Flint: I did.

Andrew Lansley: The Minister did not say that. That is what must be done and she is confusing the aggregate data—it is astonishing that she carries on doing so—on whether we are making progress in improving the health outcomes of the whole population with the question of whether the poorest and the least healthy people in this country are improving their health faster than the rest of the population. They are not, and the Government should acknowledge that fact so that they can do something about it.
	I asked some questions about evidence, which is central to the issue. If there are two things that have bedevilled the tackling of health inequalities, the first is that we just cannot agree about the causes. Of course, poverty is one of the causes. The hon. Member for North-West Leicestershire (David Taylor) made a rather absurd proposition about that and then left. Of course, there are many causes: poverty, poor housing, environment, family structures, education, ethnicity and genetics. Those are all causes.

Andrew Murrison: That is right.

Andrew Lansley: Indeed, and we could say that there have been substantial shifts over recent generations. For example, one could go back 100 years when infectious disease led to 25 per cent. of the deaths in this country. The figure is now 1 per cent., and I hope it stays that way, touch wood. What lies at the heart of the debate is the fact that we must be aware—the Minister acknowledged this—that we must not only deal with those environmental issues and the physical and societal factors that cause ill health and inequality—

Kevan Jones: Poverty.

Andrew Lansley: I do not deny that poverty is included. The hon. Gentleman will be aware of the simple fact that the latest data in the family resources survey, which are from 2003–04, show that, in the lowest quintile by income, the ratio of the top to bottom quintile incomes has deteriorated compared with 1997–98. So not only are family incomes falling in the 2003–04 data, the situation of the poorest is slightly deteriorating compared with that of the richest. I do not know whether he wants to dispute that—maybe not.
	The point that I was making is that if one takes the long view, which we have to do, those environmental factors, important as they are, are at risk of being overtaken by personal, behavioural factors. Even if we reduce income inequalities, reduce the number of people living in poor housing—as has happened—improve the environment and get rid of toxins in the air, which we have done because a Conservative Government introduced the Clean Air Act 1993, and eliminate or reduce the threat of infectious diseases, behavioural issues may still mean that some health inequalities are intractable and not reduced.
	In some parts of the population obesity rates may be higher, drug taking may be higher, smoking may be more prevalent, alcohol intake may be higher and sexual health may be worse. [Interruption.] I do not dispute that the Minister said all these things. We have to focus on them and part of the purpose of today's debate is to try to get some agreement about the necessity of acting on both sides of the equation. In the past it has tended to be the case that Labour Members talk excessively about the environmental, physical and economic factors, and Conservative Members talk rather more about the behavioural factors. We must acknowledge that we have to do both, and make progress on both. We must also be aware that, over time, those behavioural factors have begun to show how intractable health inequalities are.
	The hon. Member for North Durham (Mr. Jones) asked about more money for Easington. Easington has more money. I cannot remember the precise figure, but it is about £1,200 per head for the primary care trust, and the figure in my constituency is £880, so Easington is getting more money. If shifting resources within the NHS were the answer to health inequalities, Scotland would be very healthy. The Minister did not mention this, but the lowest life expectancy in this country is in Glasgow, at 69.1 years for men compared with 80.1 years for men in East Dorset. I am not aware that East Dorset is thick with NHS resources.

Kevan Jones: It was interesting to hear what the hon. Gentleman said about behaviour, but inequalities in parts of my constituency and other parts of the Durham coalfield were caused by the last Conservative Government.

Stephen O'Brien: Rubbish.

Kevan Jones: The hon. Gentleman may say that but, overnight, villages lost their economic heart, so there was increased worklessness, and things such as drug taking increased. I am sorry, but the hon. Member for South Cambridgeshire (Mr. Lansley) cannot stand here today and say that that Government do not have some responsibility for the poor health and inequalities that still exist in some of the former mining villages in County Durham.

Andrew Lansley: I am not sure that the hon. Gentleman heard me say that the last Conservative Government had no responsibilities. Did I say that? Perhaps he would like to demonstrate where I said that.

Kevan Jones: Is the hon. Gentleman then prepared to apologise to individuals and villages in the north Durham coalfield and other parts of County Durham for the last Conservative Government?

Andrew Lansley: I will certainly apologise for the fact that health inequalities did not narrow more under the last Conservative Government if the Minister will get up and apologise for the fact that health inequalities have widened since 1997. She is not going to do that, as the hon. Gentleman knows. I will not apologise—I have come across this point before—for what the last Conservative Government did. As it happens, I was not a politician at the time but a civil servant, and I stood next to Norman Tebbit when he signed the deal with Nissan to bring that business to Sunderland. The transformation of the north-east economy did not happen post-1997; it began in the mid-1980s. I know, because I was there.
	If we are to tackle health inequalities, we must be aware of the serious problems coming down the line. The Minister referred, for example, to the incidence of smoking among young women. There is also the increase in consumption of alcohol among young women. I was talking recently to Professor Roger Williams, who treated George Best. He is seeing in his surgeries young people, and increasingly young women, who have liver disease which to all intents and purposes is irreversible. That will be an enormous burden of mortality and morbidity in years to come.
	At the rate we are going, obesity will in three or four years overtake smoking as the principal cause of avoidable death in this country. The Minister will know that over the past 10 years—before the hon. Member for North Durham chastises me, this is not a trend that was established in 1997, although it has continued over the past eight years—the proportion of our population that is obese has risen from 16 per cent. for men and 13 per cent. for women to 26 per cent. for both women and men. Our children are getting fatter faster than any other children in western Europe.
	If that does not change, we will have an epidemic of weight-related diseases such as diabetes, stroke and heart disease; we will have an epidemic of mental health problems as a result of drug abuse; we will have an epidemic of liver disease as a result of the consumption of alcohol; and we will have an epidemic of infertility and related disease—pancreatic inflammation in respect of chlamydia and related sexually transmitted infections. The Minister did not mention the fact that the number of sexually transmitted infections has doubled over recent years. These things have to be tackled.
	The Minister did not talk either about the structure of public health services. One of the things that I said before the election was that we needed a new structure. We must ensure that the focus is institutional and financial as well as political, and it is not at the moment. There may be professional leadership from the chief medical officer—even if he had to fight Ministers in order to get through his view on smoking—but the service is not integrated. We have the functions of the chief medical officer on the one hand and those of the Health Protection Agency on the other. Out in the field, directors of public health in primary care trusts must be tearing their hair out trying to get public health messages through the chaos and noise of PCT reconfiguration. Before the PCT restructuring was mooted by the Government, directors of public health found their priorities pushed to the margin, with the single exception of stop-smoking services, to which the Government attached a target.

Diana Johnson: Will the hon. Gentleman comment on the joint public health director of the PCT and the local authority in Hull, who has been able to get out a clear message to the local authority and health services in the area to promote things such as healthy school meals? We have free healthy school meals in all our primary schools, which leads to the issue of obesity which the hon. Gentleman mentioned. That is a positive thing, which Labour has delivered.

Andrew Lansley: I am grateful to the hon. Lady for mentioning that point. She clearly has not read, and should read, Conservative party policy at the last election. It was the Conservative party's policy—my policy—that we should have jointly appointed directors of public health between the NHS and local government. [Interruption.] Is the Minister saying that that is now her policy? It is not actually her policy. It is happening in some places and it is welcome, but it should be a policy. We are here to debate the Government's policy and not what is happening only in some places.
	Health improvement and preventive services are patchy in quality and variable in coverage across the country. That is not me saying that; the Government were saying that in their "Choosing Health" White Paper in November 2004. Why is that so? It is because there is no distinct, discrete organisational function or financial structure that ensures that public health is focused in individual localities. The Government do not even know how much money is spent on public health. They cannot measure it because it has been absorbed into primary care trust allocations. I have asked how much is being spent, but I have not received a reply. We also need evidence, and I have asked the Minister about the evidence for the things that were being thrown like bones to the press before the publication of the recent White Paper.
	Surely health action zones were intended to be part of the piloting of innovative mechanisms for delivering improved public health and a reduction in health inequalities. Some Members no doubt remember the setting up of 26 health action zones across the country. Can the Minister tell me what happened to them and what the results were? The concluding comment in a draft report on the national evaluation of health action zones—it says that it is not for quotation, but I will quote from it—states:
	"It remains to be seen whether these will impact on health inequalities in the longer term."
	I will not try to quote from the rest of the report, because it is rather difficult to disentangle, but the thrust of it is that it is vital to influence the mainstream—something that was not done—and that, if one is going to achieve these things, it is vital to have a focus that is not interfered with by constant diktats on priorities from the Department of Health. Health action zones were not free of such interference, and were constantly being told what to do by the Department of Health.
	Health action zones were set up as a gimmick, and the poor people charged with running them found that the zones were marginalised. There were other priorities and, in the end, the evaluation did not show that the zones had had much impact. That is the nature of the Government's approach—it is one gimmick after another. The Government announced lifestyle checks in the press prior to the publication of the White Paper, and the implication was that they were going to be of immense benefit. On every occasion that we have mentioned them, Ministers, including the Under-Secretary, have moved closer and closer to the proposition that they consist simply of reminding people at certain points to think whether they need to visit their doctor, and no more than that.
	A great deal could be done that would be beneficial—and I keep telling Ministers so—but not necessarily at the age of 11, 18 or 50. If Ministers believe in the checks, where are the school nurses? The hon. Member for Kingston upon Hull, North (Ms Johnson) mentioned the initiatives that have been taken in Hull, but where are the school nurses that should be in every school so that health services have a consistent visible presence for young people between the ages of 11 and 18, and, indeed, under 11, and can encourage them to understand how they can improve their health and to understand the risks that they run. Those are precisely the things that impact on behaviour, and which are important in the most deprived areas of this country if we are to change the behaviour of young people in those areas.

Rosie Cooper: I wonder whether the hon. Gentleman has heard of Healthworks and various programmes operated by the St. Helens and Knowsley primary care trusts. They operate what some people would describe as fitness checks. Others might call them very quick medicals. People are tested for their weight, cholesterol and various other things. Those tests give an indicative view of whether they should go to see their doctor. They do not take place in a surgery. In Knowsley, they take innovative form, as they take place in working men's clubs and youth clubs. The people involved in the programmes are attacking the health inequalities. That is the kind of thing that we need to push.

Andrew Lansley: Of course we need to reach out. Perhaps the hon. Lady was not in the Chamber when we discussed the White Paper when I said that the pharmacy contract was a very good example of such initiatives. It is perfectly possible for pharmacies to offer a range of opportunities, including cholesterol, chlamydia and blood sugar tests. I have seen, for example, what Lloyds pharmacy has done to promote diabetic testing among south Asian groups. There are many opportunities for such tests, and the pharmacy contract permits them. The problem is that the primary care trusts are not commissioning them. Pharmacies are keen to offer testing. That would be particularly beneficial for men, who go into pharmacies for various reasons. Given the large disproportion between women attending GPs' surgeries and men attending GPs' surgeries in the middle years of life, that would be a good way of offering men health tests. It is important that that is done.
	The record that the Government published in mid-August last year shows a failure to achieve their national targets. They have not failed in every respect, but there are too many trends in the wrong direction. There are as many negative warning signals as positive ones. An improved public health structure is vital to overcome that.
	Health inequalities include not only inequalities of outcome, but inequalities of access, which must be removed. There, too, the Government have recorded a significant level of failure. It would be excessive for me to list them all, so I shall highlight a few examples, such as the availability of drugs. There are inequalities in the availability of specific drugs such as Herceptin not only between primary care trusts in England, but between England and Scotland in respect of that and other cancer drugs.
	There is also a substantial disparity between the United Kingdom and other countries. Not least because of the work of Cancer Research UK and other cancer charities, we have more and, I would argue, better cancer research than almost any other country in Europe, but is our take-up of cancer drugs in this country comparable to that in other European countries? No. We are slower to take up new drugs. That is deeply offensive to people in the UK. They contribute more than £40 million a year to cancer research, but the benefits of that do not flow through as fast as in other countries, unless people are willing to pay for treatment themselves.
	There are disparities in access to dentistry. In my constituency there are virtually no opportunities to register with NHS dentists, and that is true of many other constituencies across the country. We have disparities in access to health services. We heard from my hon. Friend the Member for Beverley and Holderness (Mr. Stuart) about community hospitals being shut down. That was happening but has been reversed, under the campaigning pressure that we brought to bear, but those hospitals are still not safe by any means. Especially for people in rural communities the length and breadth of the country, those hospitals—

Ann Winterton: I am grateful to my hon. Friend for raising that matter. It is vital for my constituency, which is predominantly rural—not just farmhouses dotted round the countryside, but small towns and large villages, where access to services at the district general hospital will be jeopardised by the future health care programme. Maternity, obstetrics, paediatrics and children's services may be removed in an area where one in six people does not own a car and there is no meaningful transport. Is that not another example of health inequalities between the rural and the urban areas?

Andrew Lansley: My hon. Friend is right. We must address such inequalities of access and, like so many of the problems that we are discussing, that is not achieved merely through changes in the NHS. A wider range of changes are needed to tackle rural issues.At the outset, the Minister mentioned Sir Donald Acheson's report of 1998. Of 39 recommendations in the report, only three were directed to the national health service, so the problem goes wider than that.
	In our earlier exchange about resource allocation, the Minister made some perfectly fair points but she did not answer the question. Resource allocation is still being decided across the country on the basis of assumed and aggregated data in respect of deprivation and age. We increasingly have data that would allow known morbidity in a community to be the basis on which NHS resources are allocated. I hope that the advisory committee on resource allocation will start to make those changes. That would make an enormous difference to many parts of the country.
	At the same time, we should isolate the resources that have to go to any community to provide good-quality services to meet the levels of mortality and morbidity that are occurring in those places, and, as distinct from that, recognise the need for separate allocated resources to impact upon health inequalities and poor outcomes arising from a wide range of factors. That separation was part of our policy at the last election, and I am still convinced that it is right to have dedicated public health resources. Otherwise, we end up in the current situation, with, for example, dramatic disparities between the allocation of resources in England, Scotland and Wales. Because those resources are not necessarily being directed to public health outcomes in some places, they are not necessarily delivering the best health outcomes.
	I saw an example of that when I was in Manchester last week. Hope hospital in Salford is taking large numbers of referrals from Northern Ireland, with referral letters going back to 2001. Northern Ireland does not have small amounts of money going into it for the provision of hospital services—it is just that it is extraordinarily inefficiently provided. It is evident that the shifting of resources across the country is not reducing inequalities of access or of outcome. It is all about delivering a reformed system.

Geoffrey Cox: My hon. Friend may be aware of the report commissioned by the Department for Environment, Food and Rural Affairs in December 2004, in which the Institute of Rural Health reported on a survey of various agencies responsible for the collection of data from which funding decisions would subsequently be made. It said that the majority had no idea that they should be looking at rurality factors or collecting data against the definition of rurality, and were not gathering information that enabled anybody to distinguish between rural and urban areas and thus to make fair decisions for rural areas.

Andrew Lansley: I am grateful to my hon. Friend. I do recall that. My hon. Friend the Member for Westbury (Dr. Murrison) has published some material of his own on how we could deal with rural health problems and inequalities of access.
	The principle of evaluating policies for their impact on health inequalities is established in theory, but it has to be carried out in practice—it is a rigorous process. Technically speaking, that is what the Acheson report recommended. I am not sure how well that has gone recently, given the inclusion of the Airdrie and Shotts provisions in the Health Bill at the end of last year.
	Inequalities of access need to be tackled. The Government were right to point in their White Paper to the wide disparity in the availability of GPs in different parts of the country relative to their populations. I was entertained and impressed by the article from Simon Stevens, a former adviser at No. 10, who said that the language used in the White Paper exactly mirrored that used in 1920 in relation to the distribution of doctors across the country. These are intractable problems, but we have to tackle them—I make no bones about that. We have to ensure the availability of services in the community, notwithstanding whether GPs want to be self-employed principals in general practice in some parts of the country.
	I want to close with one further thought. As I said earlier, it is always invidious to try to single out major disease groups, but the Government, right at the start of their time in office, singled out cancers and coronary heart disease. I know why they did it, and it was not a dishonourable thing to have done, as cancers and coronary heart disease were the largest and most avoidable killers. However, the time has come for there to be a wider range of clinical priorities and for their distribution to be much more determined by clinicians, practitioners and professionals than to be dictated by a narrow range of Government targets. Stroke is a classic illustration of that. The National Audit Office report identified many things that could be done today that would not only deliver substantial improvements but save more than 500 lives a year. That is the same number of lives that we set out to save in the Health Bill on Tuesday as a result of the changes to smoking. If the NHS took some of the necessary measures, such as immediate CT scans, 500 lives could be saved today. That would save the NHS money. It would not cost it any more; it would not only be value for money but would reduce the cost of treatment. The same, as I said, is true for lung disease and the availability of pulmonary rehabilitation, for example.
	Such matters have to be dealt with, but for lung disease—for all that chronic obstructive pulmonary disease is a real killer—the disparities are striking. I was astonished to read that in the north and west mortality rates are 30 per cent. above the national average; in the south they are 30 per cent. below the average. Those are massive disparities. [Interruption.] Well, if the hon. Member for North Durham knows that, why is it not on the Government's priority list? Why is there no national service framework, since that is supposed to be how the Government have addressed such matters over the years? Why is the British Thoracic Society having to argue for a national service framework? Why has no national clinical director dealing with respiratory diseases been given the status of others? Why is there not pulmonary rehabilitation? Why do we not have routine spirometry in GP practices? If the hon. Gentleman wants those things to happen, why did he not intervene on the Minister to ask for them rather than intervening on me?

Kevan Jones: I will not take any lessons from the Conservative party on COPD. The Government put in place the most generous compensation package for those miners whose health was ruined while the hon. Gentleman's Government refused to settle those claims for many years. It is a bit rich if he is trying to say that now.

Andrew Lansley: The hon. Gentleman should understand that I am not asking him to take lessons from me, but from the British Thoracic Society. I am sure that even those former miners would take the view that the fact that they have been given compensation does not mean that they should not receive the highest quality health services. Of course they should, and that is what we are arguing for.
	To tackle health inequalities we require a focus on the evidence of the disease group from which those inequalities come, on the behavioural and environmental factors and on an understanding that relative inequalities will not necessarily be overcome, even if at the same time we—like countries across the world—improve aggregate health outcomes. As in the debate about Herceptin, if it is a national health service, the national part demands equitable access to services. It should not be distorted by the centre's failure to understand what clinical criteria should be applied on a consensual basis or by distorted funding from the Government to try to advantage some areas of the country. If we do all those things and improve the public health environment, I hope that in years to come a new Conservative Government will bring our reports back to the House and show that we have tackled and reduced health inequality.

Siobhain McDonagh: I am pleased that the subject of today's debate is tackling health inequalities because I have tried to address that issue in my constituency since my election in 1997. I have had first-hand knowledge of the Government's commitment to confronting and dealing with inequalities. Last week, more than 250 people from two council wards in the south of my constituency braved a freezing February evening to attend a small reception hosted by the London borough of Merton and me to thank my right hon. Friend the Secretary of State for saving their local general hospital, St. Helier. They wanted to thank her for listening to their concerns. Many were elderly or infirm and they had suffered for years as a result of inequalities in the health service, but they wanted to celebrate because they were so delighted that the health establishment's decision about where to locate a new hospital had been overruled in order to tackle health inequalities.
	Inequalities in health care had become virtually unchallengeable by the end of 18 years of Conservative Government. My constituency is one of the most disadvantaged in our strategic health authority's catchment area, with some of the greatest health needs, yet through the 1980s and 1990s, when the axe had to fall, it was my constituency that suffered the cuts. As a local councillor, I spent many years campaigning against plans to close our local community hospital, the Wilson hospital in Mitcham. I led thousands of campaigners in the fight against the local authority, but eventually the Tories won and Mitcham and Morden lost its last community hospital. Thankfully, the campaign to reopen the Wilson has carried on, and now, eight years after Labour came to power, we have learned that we are finally going to get our Wilson back. The Wilson is only one example of how the health establishment targeted Mitcham and Morden. In the past few months, we have uncovered secret local authority plans, dating back to the mid-1990s, in which the authority proposed to close our nearest general hospital, St. Helier. Thankfully, it was unable to do so before Labour came to power.
	The health establishment has scorned Mitcham and Morden for many years, and even now, despite many complaints from me, there is still no one who lives in Mitcham and Morden on any of the NHS boards that make decisions about the lives of the people living there. So I should not have been surprised when St. Helier came under threat again more recently. It was saved only after the intervention of my right hon. Friend the Secretary of State for Health.This is a salutary tale. St. Helier is not actually in my constituency, but it serves half my constituents. It is part of the Epsom and St. Helier University Hospitals NHS Trust, which covers Merton, Sutton, Epsom and beyond, and which was created when Epsom hospital got into financial difficulties and merged with St. Helier in the 1990s. Epsom hospital had been struggling for some time, and the health authority decided to look at remodelling health care so that there would be one main hospital and several smaller community hospitals.
	The health authority argued that the site of the main hospital—the critical care hospital—was not important, as the community hospitals would take most of the people who normally go to hospital. A public consultation took place to determine whether there was agreement with the proposals, and it soon became clear that the main issue would be where to put the critical care hospital, which would house the area's accident and emergency services and acute services such as maternity and obstetrics.
	My view is that the people who need critical care services the most are those who are the most disadvantaged and have the worst health. There is a strong link between social disadvantage, the need for emergency services, and health problems such as low birth weight and teenage pregnancy. As the vast majority of those with the greatest health needs live near St. Helier, I felt that having the critical care hospital there would be the best way to reduce health inequalities. Initially, the health establishment agreed—in its original assessment, it gave St. Helier a 7 per cent. higher score than a Sutton hospital site in Belmont.
	The public seemed to agree, following the consultation. Although fewer people from disadvantaged areas take part in public consultations, and although my own surveys were repeatedly ignored, St. Helier emerged as the top choice among the public for the location of the critical care hospital. However, last January, local NHS managers voted to overturn the views of residents and to build a new critical care hospital in Belmont, a very well-to-do suburb in Surrey. That decision meant that St. Helier would lose its accident and emergency, maternity and other critical care services. Belmont is one of the wealthiest areas in the country and people living close to it have very high life expectancy, very good access to health care and very high levels of private health care.

Crispin Blunt: I am grateful to the hon. Lady for giving way. This might not be the last time that I seek to intervene on her, because the issue that she has raised affects half my constituents as well. Does she accept that the critical care hospital is going to have to serve 500,000 people, which is rather more than the populations of her constituency and mine put together, by some margin? Will she also explain to the House what particular health expertise she brings, given the advice that she has consistently been given by people involved in this exercise? That advice to the hon. Lady was summed up in this way:
	"I am sorry we continue to fail to convince you that the local care hospitals will be a far more significant influence on addressing the acknowledged problems of health needs in your area than ever the Critical Care Hospital would be."
	The result of her intervention, and the Secretary of State's decision, is that her constituents will not have a community care hospital addressing health inequalities; instead, they will get a critical care hospital that addresses the needs of 500,000 people.

Siobhain McDonagh: My experience, as of Monday, is 46 years of living in the constituency, being a councillor for 18 years and being MP for the constituency for the past eight years. My experience is the same as anybody could have. I am willing to take any Member who is in the Chamber in my car to see my area and that represented by the hon. Member for Reigate (Mr. Blunt). Hon. Members will not need to be health professionals to see the differences.
	Out of the 174 super-output areas covered by the East Elmbridge and Mid Surrey primary care trust, which covers the hon. Gentleman's constituency, only eight are below average in the index of multiple deprivation. I have counted at least 50 within just 3 miles of St. Helier hospital. I leave it to Members to judge whether the decision on locating a hospital should be based on 50 areas within 3 miles of a hospital or the eight within a PCT.

Kevan Jones: Does my hon. Friend agree that one important thing in tackling health inequality is enabling residents to sit on PCT boards and health boards? Unfortunately, the Government have made a big mistake by setting up the NHS Appointments Commission, which is leading to self-perpetuating medical bureaucracies, which in turn lead to nonsensical decisions that ignore clear need among local people.

Siobhain McDonagh: I fear that I agree with my hon. Friend that we have a real problem over who is on boards, who they represent and how representative they are. I cite my constituency as a prime example of that.

Rosie Cooper: If PCTs go on to be foundation trusts and have their boards of governors, or membership councils, that deficit will be sorted out.

Siobhain McDonagh: I agree with my hon. Friend, as I was a prime supporter of foundation hospitals precisely because of my constituency experience. This is the only way that people from Mitcham and Morden will get on any board of any hospital or health organisation in my area. Despite the fact—[Interruption.] I am always slightly overwhelmed by the condescension with which people's views are treated in this Chamber. I have first-hand experience of my constituency and how the health service works.
	The decision was taken despite the fact that the area around St. Helier has the greatest health needs in the catchment area and the fact that people living there have up to 10 years less life expectancy than others. It was taken despite the fact that people living near St. Helier are the least likely to have a car and the most likely to need to go to hospital. It was taken despite the fact that those in the catchment area could reach St. Helier well within the critical golden hour that our health experts agree is crucial to survival, and despite the fact that more people could get to St. Helier within 20 minutes than to Belmont, and St. Helier has far better public transport.
	Indeed, in looking at health inequalities, the programme board did not even consider access to a private car against access to public transport. In no example was the need for public transport ever taken into account. Losing those services from St. Helier would have affected not only the people in my constituency who need that hospital, but the other half of the area and the rest of south-west London because of the untenable pressure that would have been put on St. George's hospital, leading to even worse health services in another socially disadvantaged area of south London.
	Due to the harm that would be done by health inequalities if Belmont was the location of the new critical care hospital rather than St. Helier, Merton council called in the decision. The issue of health inequalities did not seem important to the local health establishment. It did not even minute letters it received from 4,000 people back in 2003, saying that the most important thing when deciding where to locate health services is health needs. It allowed only 5 per cent. of its decision on where to put the critical care hospital to be based on health inequalities.
	Then, to rub salt into the wounds, the health establishment scored St. Helier at 33 per cent. on health inequalities—just 3 per cent. higher than Belmont—yet the area around St. Helier has the lowest life expectancy, the most emergency admissions, the highest accident rate among children, the lowest level of general good health, the most people with long-term illness, the most babies born with low birth weights, the most people without access to primary care, the lowest incomes, the largest black and ethnic minority population, and the least likelihood of owning a car. Apparently, all of that was worth only 3 per cent. to the health establishment.
	It would have been cheapest for patients if the hospital were at St. Helier, but that was not addressed by the health establishment either, even though Government rules say that the cost to patients must be included in its plans. Even the health establishment admitted that were the Belmont site chosen, people living in seven of the 10 most deprived postcodes in the region would have to travel further than they do at the moment. Despite public agreement and all the evidence supporting St. Helier, the health establishment discovered new evidence, which has since been discredited, and decided unilaterally to remove services from St. Helier.
	In the face of that, the Government have demonstrated once and for all, to the whole NHS, that health inequalities matter. Merton council was brave to take on the powers that be and refer the decision to the Secretary of State, who was also brave, because she must have been under a lot of pressure from the health establishment, and the decision must have been close. She has come down firmly on the side of reducing health inequalities, however.

Crispin Blunt: I will address some of these issues if I have the opportunity to catch your eye later, Mr. Deputy Speaker. The hon. Lady has not addressed the central point of whether a critical care hospital that has to address the needs of half a million people is the appropriate vehicle for addressing health inequalities when the choice is between that and a community care hospital.

Siobhain McDonagh: If I had the opportunity, I would ask the hon. Gentleman how many super-output areas in his constituency are in the most deprived quarter in England in the index of multiple deprivation. I understand that there are none in the whole county of Surrey. In fact, there are more super-output areas in Surrey in England's most affluent 0.5 per cent. than in the whole of the bottom 50 per cent. I would have thought that he would agree that just because inequality in Surrey means inequality between the fabulously wealthy and the merely well-off, that does not mean that Surrey needs better health services than constituencies such as mine, where the inequalities are between the poor and those who just get by.

Crispin Blunt: The hon. Lady should not seek to characterise my constituency, which she plainly does not know. In my constituency, Merstham and Preston—which will become part of the Reigate constituency after the next general election—are the two most deprived wards in Surrey, and the people who live there face particular social and economic challenges. If she knew my constituency better, she would not make such remarks. We all come to this place to represent the interests of our constituents—

Mr. Deputy Speaker: Order. I am sure that the whole House is interested in this exchange, but the hon. Gentleman seeks to catch my eye, and might do so later, so I suggest that he contains himself until then.

Siobhain McDonagh: I do not wish to test your patience, Mr. Deputy Speaker, but I said that there are no super-output areas in the hon. Gentleman's constituency that fall into the bottom quarter of wards in the multiple deprivation index. While I understand completely that some less-well-off areas in his constituency face challenges, those challenges are nothing like those faced in my constituency.
	The 250 people who came to our celebration wanted to thank my right hon. Friend the Secretary of State for Health for her decision. They wanted to thank her for caring about the tens of thousands of people from disadvantaged areas whose health will now be improved by having a brand new hospital on their doorstep in St. Helier. That is why I am grateful for this opportunity to pass on the thanks of my constituents to the Government for being serious about tackling health inequalities.

Stephen Williams: We have had a wide-ranging debate, although we have focused rather narrowly on Surrey in the past 20 minutes or so. I want to go back to where we left off on Tuesday night, when, collectively, we made probably the biggest advance in public health legislation for decades by passing a full ban on smoking.
	The prevalence rates for smoking are illustrative of the wider health inequalities that exist throughout society. I looked at the statistics for the south-west of England. The highest prevalence of smoking is in my own city of Bristol, where it is 33 per cent., and the lowest is in an area that has been mentioned several times today, east Dorset, where it is 20 per cent. There are also great variations within areas. In the Henleaze ward in my constituency the figure is 12 per cent., while in the Knowle West ward, in Bristol, South, the constituency of the Paymaster General, it is as high as 56 per cent. Those wards are only about two and a half miles from each other. There is an enormous variation in quite a small geographic area. In broadly middle-class parts of the city, the prevalence of smoking is below 20 per cent. In working-class or deprived communities it is always over 40 per cent., and in some areas over 50 per cent. Throughout the city, the rates are higher among men than among women.
	Perhaps the key vote on Tuesday night was on whether we should remove the exemption for private members' clubs. Several Members, mainly but not exclusively Conservative, said that attendance at a private club was a matter of choice. Had I been called to speak, I would have said that where people go in the evenings is often not a matter of choice. In many parts of the country, particularly south Wales, where I grew up, going to a private members' club rather than a pub is the norm. If we had not removed that exemption, health inequalities in such areas would have widened rather than narrowing.

Andrew Lansley: The prevalence of smoking is probably higher in Liverpool. Did the hon. Gentleman note that the Minister of State, Department of Health voted for the exemption?

Stephen Williams: That is interesting. I assume that the hon. Gentleman is referring to the right hon. Member for Liverpool, Wavertree (Jane Kennedy). I admit that I did not note that she voted for the exemption, but I am sure that the people of Liverpool will take careful note. As the hon. Gentleman will know, an excellent organisation called Smokefree Liverpool is promoting a private Bill to impose a full smoking ban throughout Liverpool—of course, it will not now be necessary—led by Liberal Democrat-controlled Liverpool city council.
	Health outcomes are not always a matter of choice. They are often related to the accident of where people were born, their family circumstances, the occupation of family members, the housing in which they were brought up and the degree of poverty in their household. The hon. Member for South Cambridgeshire (Mr. Lansley) quoted from a briefing that I too received, from the British Thoracic Society, about chronic pulmonary diseases such as bronchitis, emphysema and asthma. Those diseases can often be linked with occupations in declining industrial areas. It is a complicated picture.

Kevan Jones: In the days when I dealt with the tobacco industry, the great city of Bristol was a major producer of cigarettes. Might there not be a connection between the high incidence of smoking in the city and the manufacture of cigarettes there? Will the hon. Gentleman be calling for the closing down of the tobacco industry in Bristol?

Stephen Williams: It is often dangerous to presume too much knowledge of areas represented by other Members. I do not know the hon. Gentleman's constituency, but I am sure that he knows more about occupational patterns there than I do. The smoking industry in Bristol went into decline a long time ago. I think that only very expensive top-of-the-range cigars are still produced in south Bristol, although the world headquarters of Imperial Tobacco is still there. The white-collar jobs remain in the Bristol cigarette industry, but the blue-collar jobs do not. The hon. Gentleman is partly right, however: the incidence of smoking in south Bristol can, to an extent, be linked with the fact that workers in the Wills factories were given free cigarettes almost as part of their pay.
	What we did on Tuesday night to eliminate smoking in public places represents a big step towards narrowing health inequalities, but there is still much to be done. We need to deal with alcohol consumption, poor diet and other contributors to ill health.
	One thing that has not been mentioned so far today is the location of health care services. The recent White Paper on community services contains an interesting section on what the Government call "under-doctored areas"—a phrase that I had not heard before. It includes a table showing the bottom 10 per cent. of areas in England in terms of the number of general practitioners per 100,000 of population. North Manchester PCT has 41, and Wigan PCT and Blackpool PCT each have 45. The accompanying map shows a clustering of low-level GP services in the north-west, south Yorkshire and Tyneside. Of course, they are the areas of greatest general deprivation in England, and they also have some of the worst health outcomes.
	However, this is not just a north-south phenomenon. As is often quoted, Hastings is a pocket of poverty and deprivation on the south coast, so it is no surprise to discover that it has a GP rate of 46 per 100,000 people—a figure that matches those for the north of England. According to the Department of Health, a GP rate of 58 per 100,000 people constitutes under-doctoring. On comparing PCTs across the country, it is clear that rural and more prosperous urban areas have twice as many GPs per head of population as the bottom 10 per cent. of areas that I just mentioned. Interestingly, that distribution has not really changed since the NHS was formed in the 1940s. So Aneurin Bevan's vision of a health centre for every community in the country is still not that close to being realised, 60 years after he pioneered his service.
	There is, therefore, a correlation between a low concentration of GPs and the worst health outcomes. Given that the general trend of the White Paper is to move the focus of health care away from secondary and toward primary care—and, we hope, toward preventive care as well—it is all the more important, as we undertake that switch, that PCTs with under-doctored areas be given the incentives and resources that they need to ensure that everyone has access to a GP.
	As the hon. Member for North-West Leicestershire (David Taylor)—he is no longer in his place—said earlier, men are notoriously reluctant to visit their doctor. Teenage boys are often taken reluctantly to the doctor by their mothers, and men are often pressured into going by their partners. It is true that in many ways, men can be their own worst enemies, and not only in terms of visiting GPs. Men are three times more likely than women to become an alcoholic, and four times more likely to have a drug addiction. They are also more likely to be obese and to smoke. As the hon. Member for South Cambridgeshire said earlier, we should not overlook our responsibilities in this regard. It is not simply a question of the Government providing services; we must all behave responsibility. None the less, according to the most recent figures from the Office for National Statistics, male life expectancy is 76.3 years, whereas female life expectancy is 80.7 years.
	The House Magazine, of which we are all doubtless avid readers, ran a supplement on men's health in its 30 January edition. It contained some interesting articles, including one by me.

Andrew Lansley: Quote yourself.

Stephen Williams: Do not tempt me. The introductory article was written jointly by Professor Nesse and Daniel Kruger, and the following quote sums up the situation:
	"Being male is one of the largest demographic risk factors for early mortality".
	Of course, disparities have always existed and are often due to different working patterns, warfare, child-rearing and so on. None the less, at the start of the 21st century, social class is still a factor affecting health outcomes, and men still die younger than women do. Indeed, men are twice as likely as women to develop one of the 10 most common cancers affecting both sexes, and especially bowel and lung cancer, but there remains a great disparity in outcomes in respect of cancers that are peculiar to gender. We heave heard about breast cancer already this afternoon in connection with the drug Herceptin. That debate highlights the fact that much more research is carried out into diseases that affect women than is the case with men, and that more drugs are available for women.
	On my lapel, I wear a blue metal symbol, and I get asked every day what it means. I have to make sure that it is the right way up, as otherwise people think that it has something to do with the Scottish National party. In fact, it represents a man covering his testicles and is meant to highlight testicular cancer. The pink ribbon campaign has been a great success in raising awareness of breast cancer among women, and has raised vast amounts of money for research into treatment. We need to put much more effort into raising awareness and funds in respect of the diseases that affect men.
	Bowel cancer affects both sexes. It can be treated successfully if it is caught early, but men are still more likely than women to die from it. Men in whom testicular cancer is detected early have a 90 per cent. chance of getting successful treatment. That shows that the advice and support given to people is very important, as is their level of awareness of their own health, but we also need to look at the disparities between the support and advice that are offered to disease sufferers.
	A recent survey showed that 34 per cent. of prostate cancer patients were given relevant advice and support, whereas 70 per cent. of women suffering from breast cancer felt that they had been given adequate advice and support. Again, that may be due to men's reluctance to ask for advice and so does not necessarily represent a failing, but it is true that many more organisations exist to support the health of women.
	I turn briefly to children. We know that there is a disparity in the funding for hospices for children and for adults, and a debate on that subject has been held in Westminster Hall. However, there is also a difference in the support that is given to children whose parents have an illness that may be terminal. I shall raise that matter when I visit Bristol Royal Hospital for Children tomorrow morning.
	Health inequalities in this country arise between men and women and rich and poor, but inequalities due to race have not been mentioned much in this debate. The hon. Member for South Cambridgeshire mentioned the NAO report on stroke care, which was considered at last Wednesday's sitting of the Public Accounts Committee. A surprising fact that emerged from the report was that black and ethnic minority people are far more likely to die from strokes than are white people. No explanation of that finding was given, but it is clearly worth further investigation. Moreover, a black African person is 44 per cent. more likely to be detained under mental health legislation.
	Last week, the Minister and I debated sexual health and HIV in Westminster Hall, where I said that it had been shown that 45 per cent. of new HIV cases in the city of Bristol in the past two years involve black African men. That is especially significant, given that they make up only about 4 per cent. of the population. When we attempt to tackle health inequalities, we must look at the awareness of certain groups in society. We must tackle their reluctance to discuss their diseases, try to remove the stigma attached to doing so, and encourage them to find professional help.
	We need better access to services targeted at people who are at the greatest risk, and to ensure that interventions are made earlier. To that end, I welcome the Government's proposal, contained in the White Paper, to introduce so-called health MOTs or life checks, but I hope that they will be targeted at those most in need.
	That raises questions about joined-up Government. I am a member of the Education and Skills Committee, which this week looked at how educational attainment varies between declining industrial areas and more prosperous parts of the country. In Bristol, the Bristol, West constituency has the highest uptake of higher education in the country, and the Bristol, South constituency has the lowest access to higher education. Educational attainment is also linked to poverty and therefore ill health.
	In the early 1970s, statistics show that men were twice as likely to die young if they came from an unskilled group than if they came from a professional or managerial group. Thirty years on, they are three times as likely to die young. At the start of the 21st century, the difference in life expectancy between those who live in Dorset, which has been mentioned several times, and those who live in Manchester is 9.5 years for boys and 6.9 years for girls. The hon. Member for South Cambridgeshire mentioned Glasgow as an area where such health inequalities are starkly obvious, and I would add the south Wales valleys.
	We have had a century of state intervention in health care under Governments and coalitions of all three parties. We have 150 years of public health legislation and worker protection laws. We have a society with greater wealth and prosperity, better homes and safer working conditions, and we are all living longer. Although rich and poor are living longer, the poor have not caught up with the rich. The gap has actually widened on some indicators under the Labour Government and there is still much more to do.

Several hon. Members: rose—

Mr. Deputy Speaker: Order. Front Benchers have taken some 107 minutes of the total 186 minutes available for the debate. Seven hon. Members are seeking to catch my eye, which works out at a non-enforceable tariff of between seven and eight minutes each. I say that just for guidance.

Diana Johnson: I was fortunate enough last week to speak in the mental health debate and, listening to the debate today, I believe that the focus on public health and mental health has taken a step forward since 1997. For my constituency, public health is one of the key issues that we need to get right.
	The hon. Member for South Cambridgeshire (Mr. Lansley) mentioned behaviour and I have an example in my constituency. When Hull city council meets, it has a tea break at about 4 o'clock, at which it used to serve tea and cream scones. The portfolio holder for health decided that it would be better to provide apples and a bowl of nourishing soup. As hon. Members can imagine, that decision caused uproar at the time, but it sent a clear message. We are trying to promote healthy eating habits in Hull and the change sent a very positive message. I pay tribute to Councillor Glew who is battling hard in Hull to put public health at the top of the agenda.
	Hull is ranked ninth out of 354 local authorities and districts in England in terms of deprivation. It is surrounded by the East Riding local authority, which is ranked 208th. I wish to compare some of the acute health statistics and show the difference with what is happening in my area. Hull has major health risks, with a high prevalence of smoking, a high consumption of alcohol and a bad diet. Those lead to high rates of coronary heart disease, diabetes and cancer.
	I wish to make four points. I want to discuss Hull's health statistics; Hull and East Riding, and the unfairness in the funding available; what is happening in Hull now; and the positive and good aspects of what has been done since 1997. As I mentioned earlier, the local authority and the two primary care trusts in my area have a joint director of public health in Dr. Wendy Richardson, who is doing a sterling job. She has just published her annual report for 2005, in which she compares the life expectancy of men and women living in Hull and in Hambleton and Richmondshire, a rural area of north Yorkshire. She found that life expectancy for a man in Hull was 4.1 years less than for a man living in that north Yorkshire patch, just an hour up the road by car, while life expectancy for a woman in Hull was 2.6 years less. The mortality rate for Hull is 120, on a UK average of 100, which means that our rate is 20 per cent. higher than in the rest of the country. In Hambleton and Richmondshire, the rate is 89, 11 per cent. below the average.
	I was delighted that this week we took the bold step of banning smoking in all enclosed public places. In the most deprived wards of my constituency, about 50 per cent. of people smoke, when the national average is about 26 per cent., so smoking is a real public health issue in Hull. Smokers are likely to live seven years less than non-smokers. As we have heard, Liverpool is trying to promote itself as a smoke-free city, as is Hull, so it is an enormous boost for a majority of Members to say that getting rid of smoking in public places is absolutely the right thing to do.
	Coronary heart disease in Hull is about 50 per cent. higher than in the rest of England, so I contacted the two PCTs in my area to ask them about acute care for people suffering from that disease. Compared with Hull, East Riding has a higher percentage of people aged 65 or over, but Hull has higher rates of deprivation, so after taking age into account one would expect mortality from coronary heart disease, as well as rates of treatment, to be considerably higher in Hull. Deaths from CHD are much higher in Hull, across all age groups and both genders, compared with East Riding. However, after taking age and gender into consideration, the rate of treatment for CHD is slightly lower for males and much lower for females in Hull, which is shocking.
	Similarly, the number of hip replacements, after taking into account age and gender, is more than a quarter more for males in East Riding than it is in Hull. For females, the difference is even more dramatic: there are almost twice as many hip replacements—91 per cent. more—for females in East Riding, a much more prosperous area.
	Given the health profile of my constituency and the health needs of my constituents, those figures show that something is not right: there are health inequalities. People who live in East Riding may be more able and willing to visit their GPs, state their needs and demand treatment, whereas perhaps people in Hull do not have the same background and cannot stand up for themselves and say what they need, but the contrast is stark in terms of health inequalities.
	The PCTs in east and west Hull will break even in the current financial year, which is a tribute to the hard work of their chief executives, chairs and boards. However, the PCT that covers East Riding is massively overspent, so the strategic health authority has asked Hull PCTs to provide funding to meet its problems. Again, when we desperately want to put money into Hull and ensure that health inequalities are reduced, we must give money to a much more affluent, much healthier area to meet the mismanagement of health service finance there, and I am very concerned and upset about that.
	For the coming financial year, the SHA has already indicated that the PCTs in Hull must top-slice about £7.5 million, so that it can be put into the SHA's funds. That is intended to cover the problems of the East Riding and other PCTs in the area. The Labour Government need to get to grips with the mismanagement of those PCTs that are not providing the best financial management that they need. We need to ensure that the turnaround teams that are going into PCTs make the fundamental, structural changes to ensure that the PCTs meet their financial commitments and do not overspend. Despite that, Hull has a proud record in tackling public health problems.
	We have a spearhead PCT. I am proud that we have led the way with health trainers. Parents have become involved in Sure Start, which provides what is almost a buddy method of operating with young parents that has worked very well, and I understand that health trainers will do so too. They will get alongside people from their own communities and offer them expert advice and guidance about improving health. I mentioned earlier that we have a joint director of public health. That is a positive step.
	Our local authority has led the way on the eat well, do well proposals, whereby our young people in primary schools receive free, healthy school meals. They also receive fruit at break time. There is a real commitment to instil in our young people the need to eat healthily from a young age. We have also had initiatives such as free swimming for children to get them to exercise and to maintain that throughout their lives. Of course, Hull is lucky that it is a flat city, so people can cycle around it easily. We have one of the highest numbers of people cycling to work in the country.
	Excellent work is also going on in our teenage pregnancy unit. Gail Teasdale, in particular, has led the way in making that a positive way to get to grips with some of the deep-seated reasons why women choose to have children at a very early age. Our PCTs' smoking cessation rates are getting much better.
	I also pay tribute to the vibrant voluntary sector that we have in Hull. It is doing a lot of work with the health community. In particular, the Age Concern building in Hull has a healthy living centre to encourage healthy lifestyles among our older population. It has a gym for the over-60s and it is an eye-opener to go in there and see people who are well beyond 60 on their exercise bikes and the treadmill. That is the kind of vibrant voluntary sector organisation that we want to promote and work with.
	We have the gateway housing market renewal pathfinder in Hull, which is all about trying to get to grips with some of the deep-seated problems of poor health and ensuring that we have decent housing for everyone. Of course, I have mentioned Sure Start, but it has a really important role to play in making those early interventions and ensuring that young families and children get the very best start in life.
	All hon. Members recognise that we cannot just leave this to the NHS. We must make a joint effort with local authorities, parents, families and the voluntary sector. We must have the money that has been properly allocated, especially in Hull, and I explained why we are not getting that at the moment. Of course, we are allocated a little more money at the beginning because of our health needs, but we do not get the full amount because of what happens elsewhere. We took a bold step this week. Let us carry on being bold in tackling health inequalities, thus ensuring that the health inequality gap narrows for the next generation.

Crispin Blunt: I am delighted to catch your eye, Mr. Deputy Speaker, and to follow the hon. Member for Kingston upon Hull, North (Ms Johnson), but I hope that she will understand that it is the speech of the hon. Member for Mitcham and Morden (Siobhain McDonagh) that I want to focus on in particular. I think that her contribution to the debate was sparked by the fact that I told her a couple of days ago that I wished to address the issue of Sutton and St. Helier in my remarks, and I shall try to keep them brief.
	There is a substantial health and technical case against the Secretary of State's decision to overturn the recommendation of the local health community in Surrey and south-west London to site the new critical care hospital at Sutton rather than at St. Helier. The merits of that recommendation are substantial and it is the product of well over a year's work, with an enormous consultation process and the rest.

Siobhain McDonagh: Does the hon. Gentleman agree that the majority of those who responded to the consultation were in favour of St. Helier hospital?

Crispin Blunt: That does not entirely surprise me because, if one examines the scale of the hon. Lady's House postage budget, one sees that she is one of the most efficient Members at using the allowance to contact constituents. I wonder how much of the effort to get individuals to reply to the consultation was hers.
	I want to address the substance of the issue: the merits of the case. I hope that the merits of the case for Sutton against St. Helier will now be addressed judicially. There is only one way to overturn the decision of a Secretary of State in these circumstances—when the decision is perverse, unfair and, in my judgment, has been taken for reasons of party political advantage rather than because it best serves the health needs of the 500,000 people who will be served by the critical care hospital. That is to invite a judge to review the decision, and I hope that that judicial review process is now in hand to put right this manifest unfairness.
	It is not that case that I particularly wanted to deal with but the use of the term "health inequalities" by the hon. Lady in her lengthy campaign to secure St. Helier as the site of the hospital. She simply could not answer the central point that I made to her in two interventions, a point that has been made repeatedly in different ways during this debate. Primary care services and community care hospital services are far more effective at tackling the issues arising from health inequalities, particularly those arising for social and economic reasons. That is especially true under the new model proposed for hospital services in the area served by the Epsom and St. Helier trust, which serves 50 per cent. of the hon. Lady's constituents and 50 per cent. of mine.
	When I intervened on the Minister, she did not challenge that basic proposition. The hon. Member for West Lancashire (Rosie Cooper) made clear the importance, in providing such care, of getting to working men's clubs and other such institutions, if one is genuine about drilling down through the community, as the hon. Member for Stroud (Mr. Drew) put it, to address health inequalities.
	It is unforgivable to put politics ahead of the genuine interests of our constituents. The reason I am so severe towards the hon. Member for Mitcham and Morden is that this is not the first time that this has happened to me and my constituents. I am afraid that we had a very similar case in 2001 when a Labour Secretary of State for Health decided to intervene in the provision of secondary care in the south of my constituency, imposing a moratorium on the reorganisation of services between Crawley hospital and East Surrey hospital. That cost the trust £10 million a year, delayed for three years the implementation of important advances in services for my constituents and has left the trust burdened with the largest deficit of any secondary health care trust in the United Kingdom. That is a direct result of the intervention of the Labour Secretary of State for Health for party political reasons. I have produced a full memorandum on the issue and I regret to say that I will have to repeat it for what has happened in the north of my constituency for my constituents there.
	During all the hon. Lady's efforts to secure the siting of the new critical care hospital at St. Helier, the fact that a community care hospital would be a more effective way of addressing health inequalities was repeatedly explained to her.

Siobhain McDonagh: I apologise to Members on both sides of the House for intervening again, but this is the last time I will do so. Who needs access to maternity care led by consultants? It is young women who smoke and have babies at an early age. Who needs access to an A and E department? It is people who do not have a GP. Those are the people in my constituency, so I certainly reject the idea that local care hospitals can meet the needs of my constituents and others surrounding the St. Helier site.

Crispin Blunt: Three miles away from the St. Helier site is St. George's hospital in Tooting, 4 miles away is the Kingston general hospital and 5 miles away is the Mayday hospital. A rather greater distance away is the East Surrey hospital, whose trust has the largest deficit in the country. As a result of the Secretary of State's intervention, 7,000 more people will present themselves at the A and E at that hospital and there will be 800 more in-patients, which will require an additional 25 permanent beds. That hospital cannot cope at the moment. The situation is bizarre. A simple examination of the map would suggest where the new hospital should be sited. The consequences for the 500,000 people who are to be served by the critical care hospital and for those whose services will be deflected to other hospitals should be taken into consideration.
	The party political interest in having the big institution with the flag on it close to home is being disguised. Everyone when asked says that they want the critical care hospital close to them; it was the only common factor throughout the consultation process. That we all want it as close as possible comes as no surprise, but the hon. Lady should know, because she was told so repeatedly, that addressing health inequalities in her constituency and anywhere else is about the effectiveness of primary care and community care. Critical care hospitals serving 500,000 people are not as important in addressing health inequalities. She knows that, I know that and, far more importantly, all the health care professionals involved in putting together the proposal know that. Yet the Secretary of State has intervened to overturn the recommendation of all the health care professionals, contrary to the view of the consultants, doctors and everyone else who will be involved.
	The really dispiriting thing is that if the hon. Lady succeeds—I sincerely hope that the last throw of the dice on behalf of my constituents in taking the issue to a judge will overturn the decision—the opportunity for a world-class hospital in association with the Royal Marsden in Sutton will have been passed up. That site would have attracted the very best doctors and consultants to serve the people whom both the hon. Lady and I represent. If the decision is allowed to stand, it will be a tragedy for 500,000 people.
	It is a great shame that the hon. Lady has put the party political interests as she sees them in her constituency ahead of all the evidence about what is needed to address health inequalities. She has campaigned for an outcome that might suit her own political interests, but I regret to say that the health interests of her constituents, my constituents and everyone else who could have been served by a world-class institution on the Sutton site in association with the Royal Marsden will be so much the worse off.

Andrew Gwynne: I welcome the debate and am pleased to contribute to it. My constituency is in eastern Greater Manchester and covers two local authority areas. The first, Tameside, like much of east Manchester, contains a number of deprived areas, which consequently have serious public health problems. The second, Stockport, is considered one of the most affluent areas in north-west England, but, despite that, it must be recognised that there are areas of serious deprivation in Stockport, including parts of the borough that form my constituency. In socio-economic terms, they have much more in common with Tameside and east Manchester than with the prosperous areas of Bramhall and Cheadle in the south of the borough.
	More than 100 years ago, at the height of the industrial revolution, the city fathers of Manchester sought to make a radical improvement in the health of the growing population by ensuring a supply of clean drinking water from the Lake district. Almost overnight, the rates of cholera and other preventable diseases plummeted. That, along with other sanitation services and the provision of public parks—I believe that one of the first municipal parks in the country was in Greater Manchester—was the first major step towards greatly improving public health in our major cities. With the introduction of the NHS in the late 1940s, there was a remarkable improvement in public health. I am proud of the fact that the former Denton urban district council was among the first councils to adopt the Clean Air Act 1956.
	As a result of all those decisions, life expectancy has increased dramatically and our quality of life has been transformed from the standard that my grandparents' parents were used to. That said, health inequalities have continued, despite the steps forward over the past century. It is sad but true that to this day there remains a direct correlation between one's background, housing, environment and income, and one's health.
	I am proud that the Government that I was elected to support committed themselves at the general election to
	"tackle the long-standing causes of ill-health and health inequality by . . . tough targets to close the health gap to cut deaths in poorer communities and among poorer children".
	That will have a massive impact on my constituents, and for the better.
	Mr. Deputy Speaker, with your indulgence, I wish to focus on the work undertaken by agencies throughout Denton and Reddish to tackle issues of concern. First, as a result of the single regeneration budget round 5 funds, there has been tremendous investment in the regeneration of the most deprived parts of the constituency. In Haughton Green, SRB funding has enabled the provision of innovative community-based health services in a new joint community and health centre. The services are provided by numerous agencies, but come together under one roof to provide local people with access to housing and homeless services, local health services, benefit advice, access to the credit union, child care help and advice for young people, including advice related to tackling sexual health issues and teenage pregnancies. That superb facility has provided the local community with a new resource.
	Adjacent to the Haughton Green community and health centre are the Haughton Green playing fields. Again, spearheaded by SRB 5 and the commitment of the neighbourhood forum and local councillors, major funding was secured to refurbish completely the rather derelict, overgrown waste of space. Through community consultation, a bid for doorstep green funding was secured and that public open space in an urban area that lacks good-quality open space has been transformed into a community asset to be proud of. Not only were the football pitches drained, new play areas for toddlers, children and teens, and a new floodlit multi-purpose games area were provided. Even the old bowling green was restored after being out of action for at least two decades. Now, the area is used by all the community. A bowling club has been established and the sports development unit at Tameside metropolitan borough council ensures that the state-of-the-art sports facilities are well used by local youths in particular. That is crucial, not least to ensure that the ticking obesity time bomb is diffused in communities such as Haughton Green.
	I also want to highlight the impact that Sure Start is having in my constituency, offering access to a variety of services such as child care and health advice, providing new parents with the skills necessary to be a parent, and developing simple skills such as cooking. These are crucial in areas such as Haughton Green and other parts of Denton and Reddish. Sure Start is beginning to address long-standing problems and I am proud that my constituency will eventually benefit from six Sure Start centres. I point especially to the good work being done by Reddish Vale early years centre in the Stockport part of my seat, which provides all the services that I mentioned. It has undoubtedly been a resounding success.
	I draw to the attention of the House the work of Tameside youth service and the Tameside and Glossop primary care trust in providing services to young people throughout the borough. Whether we like it or not, many teenagers find themselves in situations where they have access to alcohol and sometimes to drugs. Usually as a consequence of being under the influence of those substances, they may be more inclined to have, or be at risk of having, unprotected sex.
	In connection with the borough's health targets and the crime and disorder partnership, the joint service offered by the PCT and the youth service provides local young people with an all-in-one support service on drug abuse, alcohol abuse and sexual health issues. As a result of the latter, teenage pregnancy levels in the borough are starting to show an improvement. I commend to the Minister the recent report of Tameside's health and education services scrutiny panels on teenage pregnancies, which describes in much more detail the progress being made in the borough.
	Finally, I highlight the proposals of Tameside and Glossop primary care trust to devolve primary care services to local communities. Three primary care centres are being developed which will provide services far more locally than ever before. A range of services previously available at only the district hospital or outside the borough will be available in the state of the art new centres. Importantly in the context of the present debate, the centres will be located in some of the most deprived wards in the borough. One of the wards, St. Peters, which is partly in my constituency and partly in the constituency of Ashton-under-Lyne, is in the top 5 per cent. of deprived wards in the whole country.
	The availability of services locally is important because too many people from areas like St. Peters do not have access to good services if those are not available in the communities. Whether because of low car ownership or poor bus services, if facilities are too far away, people will not access them, so I commend Tameside and Glossop primary care trust for taking the services directly to those communities.
	Leading and responding to the debate is a Health Minister, and a very good one at that, but I could fill up the Front Bench for this, because tackling health inequalities is a responsibility not just of the Department of Health. I have spoken of the single regeneration budget, community regeneration, the crime and disorder strategy and sports development, but I could also mention the hundreds of millions of pounds being invested by New Charter Housing and Irwell Valley Housing through stock transfer, and by Stockport Homes through an arm's length management organisation, which will bring the area's housing stock up to the decent homes standards.
	I could talk about the new schools being built and the innovative joint services being developed with the NHS and social services, or the new jobs coming into the area through redevelopment and regeneration schemes. Put simply, tackling health inequalities involves cross-cutting responsibilities. When that is looked at as a whole, the Government have much to be proud of.

Geoffrey Cox: I shall try to be brief, as I know that others of my hon. Friends want to speak.
	I listened to the hon. Member for Denton and Reddish (Andrew Gwynne) with fascination. I have begun to realise what it must have been like for the little boy pressing his nose to the window of the pie shop, wishing he could get his hands on some of the goodies. I represent Torridge and West Devon, which is one of the most rural constituencies in England. In the few minutes of the House's time that I shall occupy, I shall concentrate on rural health inequalities.
	The constituency that I represent cannot tell a story of such gladness and happiness as the hon. Gentleman has just recited. It is suffering cuts. Constituents who are in need of medical services often have to travel dozens, if not hundreds of miles to receive it. We have acute and primary care trusts in deficit. They are closing community beds, have shut down minor injuries units, and are considering further cuts on top of those. An acute hospital trust is £9 million in debt and two out of three primary care trusts are between £1 million and £3 million in debt. I know that the Government will say that mismanagement is almost certainly the only explanation for those predicaments, but I submit to the House that there is another, longer-term reason, and it has to do with the system of allocation of resources to rural areas in England.
	On 10 January this year, my hon. Friend the Member for Mid-Worcestershire (Peter Luff) asked the Secretary of State to look again at the resource allocation system for rural PCTs. He was told that a review had been carried out by the advisory committee on resource allocation and that as a result,
	"the formula takes account of the effects of access, transport and poverty in calculating health need in rural areas."—[Official Report, 10 January 2006; Vol. 441, c. 601W.]
	However, things are definitely not all right. It is widely recognised by experts who have examined the subject that the indices of deprivation which partly govern the allocation of resources fail to capture rural health needs. The characteristics that make that so are reasonably well understood, although perhaps their quantitative effects are not. What is to blame is the national weighted capitation formula, which is based on the age distribution of the population, additional need, and unavoidable geographical variations in the cost of providing services. The indices adopted by the formula use inappropriate proxies for deprivation in rural communities, and research has highlighted an inherent bias towards urban areas.
	It is absurd to apply to Torridge and West Devon a measurement that depends on car ownership. Everybody in the countryside who can possibly scrimp and save to buy a car will do so. It must be the same in the rural constituencies represented by Labour Members. If we adopt a proxy for rural health need that is based on car ownership, we will get a distorted picture of the needs in that rural area. It is absurd to base an assessment or measurement of health needs on the proportion of ethnic minorities in the seat. As we know, it is a documented fact that there are fewer ethnic minorities in rural areas, but that does not mean that there is less isolation, less poverty and less financial disadvantage. Nevertheless, that is the effect of the formula.
	As we heard earlier, rural deprivation tends to be hidden, because people living in poverty in rural areas are dispersed across heterogeneous communities. Therefore, the indices that aim to define areas as deprived ignore profound and genuine need in rural areas. People in the countryside are a hardy breed. They are proud, self-reliant and independent-minded, and there is characteristically—a researched and documented fact—a low uptake of benefits. That, too, disguises the true level of deprivation in rural areas.
	The costs of geographical variations are underestimated. Delivering services in rural areas is more expensive because of poor economies of scale, unproductive time spent travelling by health care professionals and patients alike, and additional telecommunication costs. There are additional expenses associated with transport, including higher fuel costs, providing mobile and outreach services, maintaining branch surgeries, dispersed community hospitals and providing training and support.
	The Minister has said that the current formula for resource allocation to PCTs takes rural factors into account, but if one examines the fifth edition of the weighted capitation formula, which is an 88-page document, the word "rural" appears seven times in a single section about ambulance trusts. That document states, for example, that need is assessed with reference to the number of GP surgery visits, but people in rural areas do not go to their doctors as often as people in urban areas. In rural areas, GP surgeries often involve single-handed practices; people find it difficult to attend GP surgeries for want of transport; and cultural factors sometimes prevent people from admitting that they are ill. In rural areas, one cannot depend on the number of people who visit GPs to assess the primary medical services component.
	Those are the reasons why the people of rural communities do not believe the Government when they talk a good game on delivering rural health services and tackling rural deprivation. The people do not believe them on health, and they do not believe them on education, which is another important factor in any assessment of deprivation. This year, the schoolchildren of Devon will receive £308 a pupil less than the national funding average, and next year they will receive £330 less, which is a function of the sixth worst education grant in the country. The people are entitled to doubt the Government's commitment to rural areas in the south-west.
	A radical change in direction is needed. In countries such as Australia, Canada and even Scotland, rural adjustments are made, and it is accepted that the indices for the allocation of resources are flawed when they are applied to rural areas. In those countries, systematic research is conducted to capture those needs, and although the Government have made pious noises about compiling a rural database from which to make an accurate assessment of rural needs, little has been done.
	In an earlier intervention, I referred to the December 2004 DEFRA technical report, which shows that most of the agencies from which DEFRA seeks information are simply not equipped to distinguish between the rural and the urban in the data that they collect. The health funding formula is based on the work of those agencies. Only last week, the Government's chief medical officer, Sir Liam Donaldson, said in the foreword to a booklet:
	"We often think of life in rural areas as being something of an idyll, but there is now a wealth of evidence highlighting issues of rural deprivation social exclusion which has a potential impact on the health of those living in rural communities."
	A concerted multi-agency approach is required, and every agency and every Department should ensure that information distinguishes between the urban and the rural. It is time for the Government to live up to the CMO's admirable sentiments.
	The Government have wept crocodile tears over the plight of the countryside for eight and a half years. Farming and tourism are the twin pillars of the rural economy, but as farming has declined, English tourism has been undersold and the way of life in rural communities has been decimated by insensitivity and neglect, we have been told that it is all right, because Labour is concentrating on the things that matter to people in the towns and the countryside—education, health and poverty. However, those claims ring hollow when they are judged by the reality in the rural south-west, where people perceive a casual indifference to their areas.
	If the real needs of rural people are not identified by a concerted and coherent effort, which I have discussed, health inequalities can only get worse. In Scotland and Wales, the devolved assemblies and their Executives recognise the importance of financial adjustments in the distribution of resources to their countryside communities. It is time that the Government did the same for England.

Jeremy Hunt: I wanted to contribute to the debate because there is a fundamental flaw in the way in which the Government approach health inequalities that leads to serious discrimination against two groups of people. Let us take as an example a child who goes to St. Mark's Church of England primary school in Godalming, in my constituency. Godalming is an affluent Surrey town, which in many ways represents the stereotype of Surrey towns alluded to by Labour Members. For the children who go to St. Mark's, the reality is different.
	Of the children at the school, 35 per cent. have special needs. Teachers have told me that in some classes 80 per cent. of the children have special needs. One teacher told me of a child fed on nothing but rice for five days. Staff turnover is high, and although the school is now on the up it is a pocket of deprivation in an otherwise affluent area and has the same health needs as the inner cities. It is somewhere where social breakdown, a lack of education and a lack of money lead to less healthy diets and worse health outcomes.
	How does the NHS funding formula, designed to tackle health inequalities, treat the families of those who go to St. Mark's? If they need elective surgery, they will have to wait two to three times longer than people in virtually any city or virtually anywhere the north of the country. They will wait 26 weeks for ear, nose and throat surgery, compared with a 13 week wait in Manchester. They will wait 25 weeks for breast surgery, compared with 15 weeks in Leicester. They will wait 36 weeks for trauma and orthopaedics work, compared with 12 weeks in Sedgefield.
	The NHS funding formula punishes poor families in rich areas, because it can only deal in averages. How does it work in practice? In Guildford and Waverley we get an increase of about 3 per cent. because of the high proportion of elderly people. The market forces factor, because of the cost of health care, increases the funding by 7 per cent. However, the additional needs factor decreases our funding by 25 per cent. because we are apparently an affluent area. So, somewhere that spends 3 per cent. less than the national per capita average is told that it should spend 20 per cent. less. Who suffers? The families of children who go to places such as St. Mark's.
	St. Mark's is 2 miles away from Milford hospital, a specialist rehabilitation hospital that the PCT is trying to close. If it is closed, the poverty in the area surrounding St. Mark's will get worse. If Haslemere hospital, just up the road, is closed—the PCT is consulting about removing all the beds—those who will suffer are not the wealthy people who can afford to go private but the pensioners on a basic state pension who do not have that choice. That is the madness of a system based on a mathematical average of health outcomes that cannot account for individual circumstances.
	One more group is badly discriminated against. Every week, 90 severely disabled children are born in this country. The lives of 90 families are turned upside down. One would think that in the fourth largest economy in the world we would look after those people properly, but for many families the help and support they get is little better than it would have been 100 years ago. A system that funds to reduce the inequality of the outcome inevitably prioritises acute care over chronic long-term conditions. According to a Mencap survey, 48 per cent. of the parents of severely disabled children get no care from the state. A further 30 per cent. get less than two hours care a week from the state. Only 20 per cent. of such families are able to get any respite at all. The result is a cycle of deprivation. Often the father cannot cope and leaves the mother to bring up the disabled child on her own. She cannot possibly work in such a situation, so the social exclusion starts and gets worse.
	Why does the health inequalities agenda fail? As my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) said, we share the objective of reducing inequalities. The agenda fails because of the neo-Stalinist focus on health outcome rather than on access to health care. If the objective is to equalise health outcomes so that people have the same life expectancy in Sheffield as they do in Somerset and in Bath as they do in Bolton, we have to be careful that a mathematical formula does not end up inadvertently denying health care to Surrey, Sussex and Hampshire to make people die more quickly there than they would in Sheffield, Manchester or Leeds.
	That approach is flawed because it ignores the fact that health outcomes are the product of choice as well as of circumstance. It fails poorer families who happen to live in affluent areas and those with long-term chronic conditions because it prioritises outcomes, and those people have outcomes that will never improve. Most of all, the approach is flawed because it simply does not work. The point of targets is to motivate managers in organisations to decide on their priorities.
	The national public service agreement on reducing health inequalities for heart disease, for example, talks of reducing mortality
	"from heart disease, stroke and related diseases by at least 40 per cent. in people under 75, with at least a 40 per cent. reduction in the inequalities gap between the fifth of areas with the worst health and deprivation indicators and the population as a whole".
	The crystal test of a target is whether an NHS manager can look at it and know what he or she should do next, but it is impossible to look at that target and know what should be done to achieve it. NHS mangers have similar targets for smoking, cancer, teenage pregnancy, obesity, infant mortality and mortality. These targets are failing, and that has been a fundamental element of this afternoon's debate. We all want to eliminate health inequalities, but we are failing to do so because the system of targets is over-focused on health outcomes and not focused enough on inequalities of access to health care.
	I am generally suspicious of targets because I want a decentralised NHS in which local GPs and managers have the flexibility to determine the health needs of their own area. However, if we are going to use targets, there should be just one or two, related to absolute improvements in health outcomes for the lowest socio-economic groups, rather than a multiplicity of targets relating to relative improvements. We must prioritise equality of access to health care as much as equality of outcome. That is vital for the elderly on state pensions, for poor families—wherever they live—and for disabled people with chronic long-term conditions. They, after all, were the people for whom the NHS was set up.

John Baron: We have had a short but useful debate this afternoon, in which hon. Members on both sides of the House have highlighted the extent to which the Government have failed to address the issue of health inequalities.
	The hon. Member for Mitcham and Morden (Siobhain McDonagh) understandably talked about local health issues, but failed to explain why health inequalities had actually widened under this Government. The hon. Member for Bristol, West (Stephen Williams) explained how health outcomes were not simply a matter of choice. In referring to differing GP availability rates, he correctly observed that access was also important.
	The hon. Member for Kingston upon Hull, North (Ms Johnson) said that life expectancy rates in Hull were poor compared with those in the rest of the country. She also talked about the need for better financial management by her local trusts. My hon. Friend the Member for Reigate (Mr. Blunt) passionately and rightly expressed his concern about the Secretary of State's intervention for political reasons in important health matters such as the siting of a new hospital, and about the adverse effect that that could have on his constituents.
	The hon. Member for Denton and Reddish (Andrew Gwynne) reminded us that the Conservatives Clean Air Act 1956 had contributed to better health outcomes, and I thank him for that. My hon. Friend the Member for Torridge and West Devon (Mr. Cox) powerfully pointed out that the cuts in health services were closing community beds and minor injuries units to the detriment of his constituents. He talked about the need for the resource allocation system to be re-examined because of its apparent inbuilt bias against rural health needs. He said that his constituents were suffering accordingly, that the real needs of rural people were not being recognised, and that that situation needed to be corrected now.
	Finally, my hon. Friend the Member for South-West Surrey (Mr. Hunt) rightly pointed out that the NHS funding formula punishes poor families in rich areas and that a high percentage of carers in the families of those with long-term medical conditions are unable to get respite care. The need, therefore, is to address access to services as well as outcomes.
	A good number of those and many other contributions made outside this place have made it clear that strategies to reduce health inequalities are not having the impact that we all want. Indeed, the Government's own figures, as was mentioned earlier, confirm that progress has not been made. The Department of Health's public service agreement target aims at reducing inequalities in health outcomes by 10 per cent. by 2010, as we have heard, using 1998 as a start date, as measured by infant mortality and life expectancy at birth—yet, as we have also heard this afternoon, a progress report made in August last year confirmed that those inequalities have widened since 1998.
	The Government's figures are not the only statistics that highlight Labour's failure to tackle inequalities in health outcomes. According to a joint study by the universities of Bristol and Sheffield last year, there is a 10-year difference in life expectancy between the most affluent and the most deprived areas of the United Kingdom. There are many other such reports.
	Clearly, those depressing statistics reflect patterns of poverty and social deprivation across the country. There is, of course, a link between poor health and poverty—something that was questioned by an hon. Member who is no longer in his place. I should perhaps say at this point that some of what the Minister has said risks creating the impression that she believes that only on her side of the House are there Members with a social conscience. Among those on the Conservative Benches, too, the wish to help the most vulnerable and disadvantaged in society is the reason we came into politics, but we sit on these Benches because we do not believe that big government and socialist dogma are the way to achieve that goal—quite the opposite.
	Having said that, we should be careful of overstating the causal link between poverty and ill health. Unhealthy lifestyle is the more direct and relevant causal factor. The Government have still not done enough to persuade people in areas with the highest deprivation levels to adopt lifestyle changes that would do most to improve health outcomes. Smoking provides one worrying example. According to the Library, 17 per cent. of those in managerial and professional occupations smoke. The figure rises to 29 per cent. among those employed in the routine and manual sector.
	Such simple facts powerfully argue for a much more ambitious public health and awareness campaign. Conservative Members pledged to put those themes at the heart of our policies if elected last year. The Government should now do the same. However, their public health record is poor. Indeed, it was described by the British Medical Association as "dilatory and disgracefully complacent" and a "calamity". Only recently, Ministers produced an unworkable smoking policy before being forced into a total ban by their own Back Benchers. Meanwhile, Labour has presided over accelerating obesity and sexually transmitted infection rates.
	As well as disturbing regional variations in lifestyles and health outcomes, there are unacceptable postcode lotteries in access to services and treatments, which has been referred to on previous occasions. Cancer is one area in which the Government have claimed a great success. Indeed, there have been improvements in services and patient experience, but cancer still exemplifies inequalities of both kinds. In terms of outcomes, a recent Public Accounts Committee report highlighted persistent and unacceptable variations depending on where patients live. For example, the figure for lung cancer deaths is twice as high in the worst region compared with the best. Breast cancer death rates are 20 per cent. higher in some regions in the north than in others, which are mainly in the south. Men with prostate cancer have a 10 per cent. better chance of surviving for five years if they live in London or the south-east than in Trent and the northern and Yorkshire regions. That is on top of the inequality already suffered by men with prostate cancer, who report significantly poorer experience of care than patients with other cancers.
	Uptake of drugs and technologies recommended by NICE also reflects wide variations, a fact recognised by the cancer tsar in a report back in 2004. We know that use of the breast cancer drug Herceptin one year after the NICE recommendation ranged from a staggering 90 per cent. of eligible women in Dorset to a dismal 16 per cent. in Essex. In relation to early-stage breast cancer, it is incredible that Ann Marie Rogers had to go to the High Court to clarify the Secretary of State's direction last autumn, in which she seemed to suggest that PCTs could not withhold the drug on consideration of cost alone. By not making additional resources available at the time, however, she might have done as much to exacerbate inequalities as to reduce them, particularly at a time of worsening deficits. The charity Breakthrough Breast Cancer commented:
	"This drug could save the lives of 1,000 women a year and it is unfair and cruel for women like Ann Marie Rogers to know that it is money and their postcode that stands between them and this potentially life-saving treatment."
	The whole situation is a nonsense caused by this Government.
	The problem of regional variations in access to drugs and technology is not restricted to cancer. Photodynamic therapy for wet age-related macular degeneration was approved for use in the NHS in September 2003. Only last autumn, however, data presented by the Macular Disease Society and the Royal National Institute of the Blind showed that 30 per cent. of people in the UK who could have benefited from PDT had not been treated.
	NICE was set up to address the postcode lottery in access to drugs and treatments. However, the Government must now address the postcode lottery in implementation of NICE guidance. In particular, they should follow the Conservative policy of ensuring that NICE appraisals are carried out in conjunction with a full resource implementation assessment, so that national guidance is realistic, implemented and successful. More broadly, NHS bodies should be subject to a statutory duty to implement NICE guidelines on standards of care as well as drugs and technologies. In a devolved health service, it is essential that patients are given clear entitlements to treatment. That will help particularly the 17 million patients who suffer from long-term medical conditions and who are increasingly realising that in a target-driven culture, conditions that are not targeted suffer unduly.
	Chiropody services for elderly people and rehabilitation services for the visually impaired are two sad examples of the type of care for long-term conditions that suffers in a devolved service when Government targets are focused on the acute sector and politically sensitive waiting times. A survey by the Conservatives showed that more than half of chiropody services had recently raised the eligibility criteria for access to treatment, with the average department undermanned by a shocking 25 per cent. Meanwhile, with regard to the nearly half a million people in the country registered as blind or partially sighted, the Guide Dogs for the Blind Association has estimated that as many as 20 per cent. of local authorities have no dedicated rehabilitation services, with nearly 80 per cent. overall admitting that services were restricted due to a shortage of suitably qualified staff.
	With an estimated half of all NHS trusts going into deficit, inequalities in local services and patient care are bound to increase. Hon. Members have already highlighted cases in their constituencies where services are being cut in order to balance the books. This latest development comes from a Government who spent years bombarding the NHS with targets and bureaucracy and then destabilised trusts with bungled reforms. The Government have not tackled health inequalities—in fact, they have widened in recent years.
	By not implementing a strong public health programme and not radically improving the NHS, the Government have failed to break the link between poverty and ill health. All the evidence suggests that when unreformed state services do not perform as well as they should, the less well-off tend to be let down the most. Meanwhile, inequalities in access to services have also proliferated. As Conservative Members have argued, postcode lotteries will be ended only if NICE is given the tools and instructions to create a culture of standards and entitlements in the NHS. Until patients have those entitlements, health inequalities will continue to widen.

Caroline Flint: With the leave of the House, Mr. Deputy Speaker.
	We have had a useful debate, and I have heard interesting contributions from Members on both sides of the House. One of the issues that have confronted the Government is 18 years of disinvestment in the NHS by Conservative Governments. During that time, services were cut in many areas. I understand that that included two dental training schools. Clearly it will take time to change a system that has suffered from underfunding and insufficient engagement for a generation.

Peter Bone: Will the Minister give way?

Caroline Flint: No, because I gave way to the hon. Gentleman during my opening speech and he did not stay for the whole debate. [Interruption.]

Mr. Deputy Speaker: Order. There should not be sedentary interruptions.

Caroline Flint: I think you will see in Hansard, Mr. Deputy Speaker, that I gave way extensively during my opening speech. As I now have less time than was taken by the hon. Member for Billericay (Mr. Baron), I want to make some progress.
	Tackling public health issues is hugely important. The situation will not change overnight, but we must accept the challenges, some of which have embedded themselves over many years. There has been an increase in sexually transmitted infections, for instance, but in many other respects we live in a world that is very different from the world of 10, 20 and 30 years ago. I pay tribute to the Labour politicians who established the national health service, but their concept of the health service that was needed then was very different from the service that we need today.
	Many other things have changed. Work has changed enormously. In my constituency, a mining constituency, the number of miners who suffer from respiratory disease is heartbreaking for those individuals and their families. At least the miners must be encouraged by the Government's decision to meet the claim for compensation for that industrial disease.
	We in the Labour party have an historic commitment to fight for ways of tackling inequalities. That has meant fighting for safe working conditions, decent housing, a national minimum wage and—in earlier campaigns—clean water, public sewerage and public parks. Those campaigns are all part of the overall picture.
	I think that all Members agree that, in general, everyone is living longer and everyone is healthier, but we must deal with the gap caused by health inequalities. One reason for that gap is the way in which services are being delivered, but there is another reason. It is interesting, but we have not much time in which to explore it. Research suggests that those who are better off and better educated can gain access more quickly to NHS services such as information and an understanding of how lifestyle choices affect health, and that that enables them to make choices more quickly. That is part of the problem. The more we provide such services, the more the better off take advantage of them before poorer people can do so. We must therefore provide services in a different way because there is no "one size fits all" solution. It is not enough to organise national education campaigns with advertisements on television, or to provide services on the internet. We need to find a better way of working in communities to give people the support that they need.

Andrew Lansley: Will the Minister give way?

Caroline Flint: No.
	Reference was made earlier to the need for people to feel confident about talking to their GPs, demanding services and making their voices heard. I am afraid that it is an indication of modern life that more affluent people are often more confident, shout the loudest and get the services, whereas poorer people perhaps have less confidence and do not. That is unacceptable. For some reason, GPs do not want to work in our poorest areas, which is also unacceptable. Perhaps they prefer working in more affluent communities.
	The hon. Member for South Cambridgeshire (Mr. Lansley) asked about reductions in the incidence of cancer and coronary heart disease, and the reductions are 9.4 per cent. and 24.7 per cent. respectively. The figures are not absolute—they constitute a reduction in the gap between the average for England and the figure applying to the five most deprived areas. I accept that infant mortality has risen: it rose by 19 per cent. in 2001–03, and by 19 per cent. in 2002–04. That is unacceptable, but there was no increase during the second tranche, which I hope shows that the situation is not getting worse. [Interruption.] I have accepted that the figure has risen, but it has stabilised and we must try to reduce it.
	On obesity, the hon. Member for South Cambridgeshire will be aware that we are doing a tremendous amount of work with the food industry and others on food labelling and the reformulation of food.

Andrew Lansley: Will the Minister give way on that point?

Caroline Flint: No, I am not going to give way.
	We are doing important work with schools through the healthy schools programme, but, of course, another important factor is the choices that parents make for their children, which is why we have to work with families as well. I should also point out that status reports on health inequalities are published annually on the departmental website.
	On public health structures, I am glad that the Conservatives agree with us about joint appointments, which we are encouraging. My first speech as Minister with responsibility for public health was made at the invitation of the Faculty of Public Health. I pointed out at its conference that, in my view, that is the direction in which we should go, and there some very good examples of such practice. However, we must recognise that it is more than just a question of appointing someone to serve the local authority and health services in a joint capacity; there must also be a change in the culture and mindset of all the organisations involved, so that they can work together. Local area agreements are important in that regard, and the consideration of health inequalities must form an integral part of the assessment of local authorities.
	The health trainers programme is based on the Bandera study, which is a psychological behaviour change model. It shows that one-to-one, structured motivation techniques empower individuals to change their lifestyles. In our view, providing such services to those who are taking advantage of other forms of information and support is a good way forward. The National Institute for Health and Clinical Excellence is working closely with us on the development of the life checks model.
	Respiratory disease is an issue that we take very seriously, and it is on our list of key interventions. However, circulatory diseases account for the largest proportion of excess deaths in spearhead areas: some 70 per cent. among males and 63 per cent. among females. By way of contrast, respiratory diseases account for some 18 per cent. of such deaths. However, we obviously all these issues seriously, and it is important to deal with them.
	My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) told us about her area and the question of where the new hospital is to be located. It has to be acknowledged that the issue is not just health inequalities and services, but regenerating communities; the new hospital will play an important part in that regard. The hon. Member for Bristol, West (Stephen Williams) talked about pharmacies playing a greater role, and this Government are providing such opportunities. Our proposal to allow pharmacies and nurses to play a greater role in prescribing will allow them to add to the role played by GPs; they will not replace GPs. They will add to the mix of people who can deliver health services in our communities. Men's health was also raised in the debate, but I dealt with that extensively in my opening speech.
	I congratulate the councillor to which my hon. Friend the Member for Kingston upon Hull, North (Ms Johnson) referred on her innovation. I welcome the fact that there is a joint director of public health in that area, but I hear what my hon. Friend says about East Riding, which does not have the same level of health inequalities as other areas, but seems to spend money rather more unwisely than does Hull itself. That is something that we should talk about more when we consider good management and delivery.
	My hon. Friend the Member for Denton and Reddish (Andrew Gwynne) spoke well about what is happening in his area, and said that it is not just a matter of health for everyone. I think that the hon. Member for Torridge and West Devon (Mr. Cox) misunderstands health inequalities. I accept that rural areas face different problems, and we have trained the health trainers programme for Devon and Cornwall—
	It being Six o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Peter Bone: On a point of order, Mr. Deputy Speaker. I seek your guidance on a matter of great importance. First, though, in the last debate the Under-Secretary of State for Health, the hon. Member for Don Valley (Caroline Flint), inadvertently misled the House by saying said that I had not been present all the way through, when in fact I had.
	On 30 November 2005, the Prime Minister said that no one had to wait more than six months for an in-patient operation. However, in a parliamentary written answer of 23 January this year, the Under-Secretary of State for Health, the hon. Member for Birmingham, Hodge Hill (Mr. Byrne), said that the NHS now operates a maximum waiting time for admissions of six months for an in-patient operation—

Mr. Deputy Speaker: Order. I understand that the hon. Gentleman has raised this matter on a previous occasion. If so, it would be wholly inappropriate to raise it again on a point of order now.

Peter Bone: It has only just come to my attention that I received two answers to parliamentary questions on the same day that are massively contradictory.

Mr. Deputy Speaker: Order. The content of answers to parliamentary questions is not a matter of order for the Chair. I think that the hon. Gentleman will have heard Mr. Speaker advise on other occasions that such matters are matters of debate that should be pursued in other ways, either through further parliamentary questions or through the other parliamentary means that are open to hon. Members.

DELEGATED LEGISLATION

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

International Development

That the draft International Development Association (Fourteenth Replenishment) Order 2006, which was laid before this House on 18th January, be approved.—[Gillian Merron.]
	Question agreed to.

PETITION
	 — 
	St. Mary's Church, Humberstone

Keith Vaz: I wish to present a petition on behalf of my constituent Amanda Palmer of 36, Ocean Road, Thurnby Lodge, Leicester, and 900 other constituents. It concerns the decision of St. Mary's parochial church in Humberstone to prevent people laying flowers and mementoes next to the graves of their loved ones. They are very distressed and concerned by the decision, and as a result of it feel that they cannot pay sufficient tribute to those who were dear to them and who are buried or interred at Humberstone church.
	The petition states:
	The petition of residents of Humberstone, Leicester, declares that St. Mary's parochial church in Humberstone, Leicester, has placed a ban on visitors laying flowers and mementoes next to the graves of loved ones.
	The petitioners therefore request that the House of Commons urge the Government to take action to encourage St. Mary's church council to reconsider its decision and allow visitors to place flowers and mementoes at the grave sites.
	And the Petitioners remain, etc.
	To lie upon the Table.

RSPB OLD MOOR WETLANDS CENTRE

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Coaker]

Jeff Ennis: I am pleased to have this opportunity to draw the House's attention to the Royal Society for the Protection of Birds's Old Moor wetlands centre in my constituency, which I believe is very much a best practice model for the Government's sustainable communities agenda.
	Given the type of seat that I represent, I am an avid supporter of the Government's sustainable communities agenda. After all, having witnessed at first hand the total devastation visited on my local communities by the previous Government's politically motivated pit closure programme of the late 1980s and early 1990s, I know that it is important that the Government ensure that future local community development is founded on the principle of sustainability. The Old Moor centre is a classic example of the type of good practice that we as a Government need to develop, in south Yorkshire and across the rest of the country.
	Twenty years ago, the site of the Old Moor wetlands was part of a much larger area known as the Wath Manvers complex which, by the early 1990s, had become the largest area of despoiled land in the whole of western Europe. Something drastic needed to be done, and the three Dearne valley local authorities—Rotherham, Barnsley and Doncaster—decided to work collaboratively on the project when they won city challenge funding from the previous Government. Indeed, my local authority of Barnsley ended up being the only local authority in England to win two city challenges, which exemplifies its efficiency and effectiveness and—I am pleased to say—that continues to this day. I would say that of course, being a former leader of Barnsley council.
	The development of Old Moor wetlands was the brainchild of Robin Norbury, a good friend of mine, the former planning chairman on Barnsley council and member for the Darton ward. It became part of the wider regeneration city challenge project to rebrand the Dearne valley. The other flagship projects under city challenge included the development of Dearne valley college, addressing the skills deficit in the Dearne valley, and the designation of one of the last enterprise zones in England, the Dearne valley enterprise zone. All those flagship projects have been highly successful in transforming the Dearne valley into an economically and environmentally attractive area.
	The Government's sustainable communities programme offers significant challenges to how we deliver genuine sustainable development. The Old Moor wetlands centre has demonstrated that it is possible to deliver green infrastructure, enhance wildlife populations and conserve natural resources while offering jobs, education and recreational opportunities to local people. The benefits from investing in wildlife and places such as the Old Moor centre are manifold. We need to convince all in Government that that is the right path to take.
	Old Moor has proven to be an excellent example of how green infrastructure can be developed to help contribute to the Government's sustainable communities agenda, and that has been achieved thanks to significant support from the Heritage Lottery Fund, Yorkshire Forward and Waste Recycling Environmental Ltd. It has also built on the splendid work done by Barnsley council to create a wetland environment and bring the reserve to the point where it is nationally important for wintering wader birds. Old Moor has helped to deliver a fantastic resource for birds and people, thanks to the generosity of RSPB members and the many funding partners who have contributed.
	Old Moor is a demonstration of what can be achieved in the restoration of former coalfields, and I hope that that approach can be replicated across the country, as part of the Government's sustainable communities agenda. Restoration of former coalfields has created excellent places for wildlife. The reserve buildings also feature renewable energy technologies and have provided new facilities for local communities, including conference facilities for local business and community groups.

David Taylor: The Old Moor project is a flagship for the restoration and regeneration of the Dearne valley and it sounds much like the Sent valley project in my own village, which is part of the wider regeneration of north-west Leicestershire. The key to that very successful project has been community involvement at volunteer level—not at employee or passive visitor level, although that has been useful. It is that volunteer involvement that has built the links. Has it also been crucial at Old Moor?

Jeff Ennis: My hon. Friend makes a valid point, and I shall come to the role of volunteers shortly. Their role is vital. Not only does it improve the quality of life of the volunteer, but it enhances the quality of life of those whom the volunteering helps.
	In all, the reserve employs 24 people and has increased the viability of local businesses by adopting a local sourcing policy. Wildlife tourism is big business. People travel to see natural spectacles, and spend money at local shops and other businesses. The total number of visitors expected by the centre in this financial year is 65,000.
	The RSPB has created a number of wildlife viewing opportunities for the local community and has demonstrated that rare species can be an asset for the local economy. For example, in the year after the foot and mouth outbreak, 70,000 people visited an osprey viewing site in the Lake district, demonstrating that the attraction of wildlife can draw people back to the countryside. Osprey watching at the nine sites in Britain managed by the RSPB is worth a staggering £2.5 million to local economies. The phenomenon is not restricted to birds of prey. Marine mammals tourism generates £8 million a year for the west coast of Scotland.
	On the education front, about 4,000 schoolchildren a year enjoy visits to experience and see renewable technologies through the Old Moor reserve's field teaching programme. Nationally, nearly 50,000 children benefit from RSPB facilities. The society believes that all children should be able to benefit from out-of-classroom learning, because all our modern technology and sophisticated teaching practices and living are no substitute for a child getting out of the classroom to experience nature and culture at first hand—getting their hands dirty, as we say in Yorkshire. That can link to, and help to achieve, many Government objectives, such as those on children's health, citizenship, social inclusion and the reduction of deprivation, crime and unemployment. The site's award-winning, energy-efficient visitor centre makes use of renewable energy technologies; it has a biofuel burner, solar panels, a wind turbine and a solar water heater.
	On the health front, physical inactivity costs the national health service about £8 billion a year. Sport is not always the best way for the majority of people to get fit, and research suggests that sociable walking in green space can be the best way to get people moving. It also suggests that if the primary purpose of exercise is contact with a high-quality environment people are more likely to sustain their activity and thus accrue more benefits.
	Health walks, such as those organised by Old Moor, and volunteering can provide people with the motivation to become active. One in six, or 18 per cent., of the RSPB's 13,000 volunteers were inactive before they started work for the RSPB, and that 18 per cent. are prepared to continue volunteering, which emphasises the point made by my hon. Friend the Member for North-West Leicestershire (David Taylor). More than 350 health walks in the UK are organised by more than 10,000 volunteers, led by the British Heart Foundation and the Countryside Agency.
	Throughout England, the RSPB is an effective delivery agent and partner in the Government's sustainable communities programme and it has plans to extend the model to help to develop a bold and innovative vision to regenerate the lower Aire valley in west Yorkshire, which includes part of the Pontefract and Castleford constituency of my hon. Friend the Minister for Housing and Planning. The RSPB believes that, as a society, we have a once-in-a-generation opportunity to build sustainable communities such as those in the Dearne and lower Aire valleys. We must make the right choices to provide the homes and jobs that people need, without jeopardising their quality of life now or in the future.
	Sustainable communities need wise planning, for which we must meet four crucial challenges. First, we must deliver a green infrastructure. Wildlife-rich spaces in and around new communities play an important role in people's quality of life. We believe that green infrastructure, such as that created at Old Moor, is as vital to us as the traditional infrastructure of roads, hospitals and schools. There should be no difference between hard infrastructure and green infrastructure.
	Secondly, we must respect environmental capacity. Even if green infrastructure is fully designed into new communities, there will still be serious questions about the overall environmental impact of development. We believe that much more needs to be done to assess, and if necessary avoid, the impact, of national and regional planning. To do that, and thirdly, we need a national spatial strategy subject to robust strategic environmental assessment.
	Fourthly, we need to conserve natural resources. Creating sustainable communities inevitably has implications for the consumption of natural resources such as fossil fuels and water. Climate change is a crucial issue, both for biodiversity and communities. To build a new home with water and energy saving measures to the eco-homes excellent standard costs as little as £160. Building on research carried out for the Department for Environment, Food and Rural Affairs, the water industry and the Housing Corporation have estimated that society could save billions of pounds on new water resources infrastructure and reduce carbon emissions. The proposed code for sustainable homes must be both rigorous and mandatory, not left to the whims of house builders.
	Finally, we need to protect and enhance wildlife, which should go without saying. The RSPB also believes that sustainable community development must protect and enhance the best bits of biodiversity. That is the test of genuine sustainable development. If we cannot protect and enhance sites such as Old Moor, we will certainly not pass our environment on to future generations in the state that they would wish.
	In conclusion, as I am sure that the Minister will know, the RSPB's mission statement is simply, "For birds, for people, for ever". I believe that that mission statement could also form part of the Government's sustainable communities mission statement, and I commend the Old Moor wetlands centre to the Minister and, indeed, the House.

Jim Fitzpatrick: I congratulate my hon. Friend the Member for Barnsley, East and Mexborough (Jeff Ennis) on securing this debate and thus raising issues about the regional and national work that is taking forward the sustainable communities agenda. My honourable colleague has been involved in the development of the RSPB's Old Moor wetlands centre since its inception and I commend him and Councillor Norbury on the leadership they have shown in supporting that important and valuable community asset. My hon. Friend was deputy leader and leader of the local council, as well as now being the very active local Member of Parliament.
	The Office of the Deputy Prime Minister is all about creating sustainable communities, and our departmental strapline and mission statement reflect that fact. However, that is much more than about words: it is about creating change, delivering diversity and implementing initiatives. That commitment comes not just from the ODPM, but from across Government. We are working closely with the Department of Trade and Industry, through the regional development agencies, with the DEFRA agents, such as the Environment Agency, and with organisations such as the RSPB to create better places to live and work, such as those in Barnsley described by my hon. Friend.
	But I should like us to take a step back: the sustainable communities plan, launched in 2003, set out the Government's long-term vision for thriving, sustainable communities in every English region. The plan defined an ambitious programme to deliver a step change in housing supply, decent homes, urban renewal and countryside protection, and it also signalled unprecedented investment in our neighbourhood environments. It also made a commitment to the environment, making it clear that it is important that new housing should be located on brownfield land where possible and that the protection of the countryside and the green belt were priorities for the Government.
	We have seen achievements in those areas. Residential development on brownfield land is up from 56 per cent. in 1997 to 72 per cent. today. The density of new residential developments has increased from 25 dwellings per hectare in 1997 to 40 per hectare. Between 1997 and 2004, there was a net increase of about 26,000 hectares in designated green belt. A further 13,000 hectares of green belt has been proposed in emerging development plans.
	The sustainable communities plan also set ambitious targets for the growth areas, including the Thames Gateway, to consider green space as part of the overall master plan. In the Thames Gateway, the "Greening the Gateway" strategy established the principle that new and existing residential and commercial areas should be set in a network of varied and well managed green space. Supported by £26 million from the ODPM Thames Gateway programme fund, a number of green space initiatives have been funded, including £3.25 million to ensure the protection of the RSPB reserve at Rainham marshes and to construct an environment and education centre; £5 million for the London Riverside conservation park at Rainham and Averley marshes and the restoration of Erith, Crayford and Dartford marshes; and £2 million to provide a 74 hectare conservation site at Nevenden nature reserve in Basildon.
	ODPM funding worth £40 million is supporting the delivery of key components of green infrastructure in the key growth locations by improving the interface between the urban and rural environments, providing improved access for people and wildlife and restoring areas of the countryside, which provides people with more opportunities to experience and interact with their environment first hand, as suggested by my hon. Friend.
	Two examples of projects being funded are Dunstable downs, which is receiving £1.5 million to provide a new flagship facility to accommodate additional visitors resulting from the nearby growth area, and the Forest of Marston Vale, which is working to transform 61 square miles of land in a key location between Bedford and Milton Keynes, with a long-term aim of achieving 30 per cent. woodland cover. A sum of £2.8 million will ensure a wide range of environment and community benefits, including landscape improvement, wildlife conservation, agricultural diversification, recreation provision, employment generation and environmental education.
	More recently, the Government's response to Kate Barker's review of housing supply reinforced the commitment to protecting and enhancing the environment alongside accommodating housing growth. As my hon. Friend can see, on a national and regional level we are working cross-departmentally to deliver sustainable communities.
	Quite a few of the examples I have cited are from the south and the midlands, but let us not forget the subject of today's debate. My hon. Friend has given us the example of the Old Moor wetlands centre in a former coalfield area in his constituency, and I am glad that he has raised the profile of the centre, which demonstrates what can be achieved in a location that could so easily have become a no man's land, or a nobody's land, to be more politically correct.
	Reflecting on what I said earlier, Old Moor certainly demonstrates excellent usage of brownfield land being, as it is, a former farmhouse and associated agricultural buildings surrounded by an area formerly used for mining with some contaminated land. Through a combined budget of £500 million, the national coalfields programme, the Coalfields Regeneration Trust and the Coalfields Enterprise Fund mentioned by my hon. Friend are delivering real change through a long-term programme and commitment to action. People are being given access to the skills and jobs that they need, the environmental legacy of the coal industry is being cleaned up, and the housing, economic and social needs of the local communities are being addressed.
	Old Moor nature reserve is a practical example of how a former coalfield site can become an important community asset. A number of the awards received by the centre mirror the Government's commitment to sustainable building. During the actual building process, the builders, Wakefield-based Tolent Construction, demonstrated high standards of workmanship and health and safety to staff and visitors. The company and the RSPB won the national built-in quality award for innovation for the visitor centre's many energy conservation measures. It has a wind turbine, solar panels and wood chip boiler supplied from a nearby sawmill.
	There are also links to education, culture and heritage through the work of the centre. Old Moor, with its extensive visitor facilities, is a fantastic place to watch wildlife, particularly a range of birds. A mix of habitats includes open water, marsh, reed beds and grassland. There are also curriculum-linked, term-time educational visits, including pond-dipping, "mini-beasting" and other creative and science-based activities to suit children from reception to key stage 2. Around 4,000 children have had first-hand experience of nature through the reserve's field teaching programme, and 65,000 visitors are expected to go through the gates during this financial year, reaching the targets set for 2008. I am sure that, as a result of this enjoyable but educational facility, a generation of children will grow up with a much wider appreciation of the local environment, and that that enjoyment will translate in later life into a caring and responsible attitude towards their community, as my hon. Friend suggested.
	As my hon. Friend said, by the first anniversary of the opening of the centre in the autumn, the RSPB work should be replicated across the country in line with the Government's sustainable communities agenda. I hope that I have demonstrated that this is happening nationally, and I certainly commend the RSPB's plans to create and enhance other wildlife areas throughout the Dearne valley. The RSPB has additional proposals for the Yorkshire coalfield area to develop more reserves. In the Lower Aire valley, it is looking at opportunities between Leeds and Castleford. It is to work alongside UK Coal Mining Ltd at the former open-cast St. Aidan site. People living, working and visiting the area will have easy access to a network of sites via new footpaths, bridleways and cycle routes.
	Moving slightly further afield from South Yorkshire but still in the Yorkshire and Humber region, North Yorkshire county council is consulting on the Swale and Ure washland project. Future sites could form a network, with high ecological, landscape and amenity value. In Wakefield, the council is working with partners through developing local area agreements to develop plans to designate a number of local nature reserves, to improve biodiversity and provide improved green spaces for the deprived communities in its district.
	I cannot finish without referring to the work of the Land Restoration Trust. It is a joint venture company, which was launched in 2004 by the Deputy Prime Minister. It is jointly owned by English Partnerships, Groundwork, the Environment Agency and the Forestry Commission, and regional development agencies are represented on its board. It seeks to hold sites, including many in the former coalfields, and to ensure that they are managed into perpetuity.
	I certainly feel that I have covered a lot of ground, both geographically and from a policy point of view. It is easy to get drawn into the minutiae of these issues, so it is good to reflect on the bigger picture, as afforded by my hon. Friend. He has raised the issue of sustainable communities with reference to the Old Moor wetlands centre. Communities are about people—people from all backgrounds, young and old. Centres such as Old Moor help to bring life to an area in many ways. That area suffered with the decline of the mining industry, but a new life is emerging, as demonstrated at Old Moor and replicated in other parts of the country. I conclude by congratulating my hon. Friend once again, not only on securing this debate, but on his solid support for our policies generally and for the Old Moor wetlands site and the creation of similar sites across the country, ensuring the building of sustainable communities.
	Question put and agreed to.
	Adjourned accordingly at twenty-eight minutes past Six o'clock.